Antibiotics are the greatest medical discovery of the twentieth century, and its discovery has contributed to the extension of human life by at least 10 years. Antibiotics were really used clinically in 1941, when penicillin was first discovered, and at that time it was a very effective drug, used in very small quantities. But now it is on millions of units of penicillin use is not very effective, and this is its resistance.
Bacterial drug resistance has become a serious public health problem worldwide. With the widespread use of antibiotics in various fields, bacterial resistance is increasing. In recent years some countries and regions have even seen multi-drug resistant bacteria that are resistant to almost all antibiotics, also known as superbugs, and humans are once again facing the threat of infectious diseases.
The principles of rational use of antibiotics
1.In order to control the infection effectively and strive for the best efficacy.
2, to prevent and reduce the adverse effects of antibiotics.
3.Pay attention to the dose and course of treatment to avoid the production of drug-resistant strains.
4, pay close attention to the patient’s body normal flora dysbiosis.
5, according to the drug sensitivity test, strict selection of drugs and route of administration to prevent waste.
Suggestions for the rational use of antibiotics
1.Patients with viral infections or viral infections with a high probability are generally not used antibiotics.
2.Antibiotics should not be used for those with unknown causes of fever and no signs of suspected bacterial infection. For those with serious conditions or bacterial infections that cannot be ruled out, antibiotics can be selected in a targeted manner, and once confirmed as non-bacterial infections, antibiotics should be discontinued immediately.
3, all suspected cases of bacterial infection, should strive to use antibiotics before the routine collection of specimens according to the disease diagnosis and treatment, bacterial culture and in vitro drug sensitivity test.
4, according to the results of bacteriological examination, combined with the clinical selection of sensitive antibiotics, or the original use of antibiotics must be adjusted. The selection of antibiotics should also pay attention to the source and price of drugs.
5, the combined use of antibiotics should have strict indications. It is generally applicable to serious infections (including sepsis, bacterial endocarditis, septic meningitis, etc.), mixed infections, refractory infections, secondary infections that cannot be controlled by one antibiotic, as well as cases that require long-term medication and are easily resistant to bacteria, with two combinations being appropriate, but with a reasonable course of treatment. The combination of antibiotics should be able to achieve synergistic or additive efficacy, without increasing adverse reactions, to prevent and delay the emergence of drug-resistant strains of bacteria. It is strictly forbidden to combine drugs without any basis at will.
6, bacterial infection caused by fever, after antibiotic treatment of normal temperature, the main symptoms disappear, timely discontinuation of antibiotics, but sepsis, osteomyelitis, bacterial endocarditis, purulent meningitis, typhoid fever, chronic pyelonephritis, diffuse peritonitis, acute obstructive purulent cholangitis, tuberculosis and certain serious infections depending on the situation.
7, a clear diagnosis of acute bacterial infection, in the use of a certain antibiotic 72h after the clinical effect is not obvious, or aggravation of the disease, should be multifaceted analysis of the reasons. If the problem is really the use of antibiotics, the dose should be adjusted, the route of administration, according to bacterial culture and drug sensitivity test results, change to other sensitive drugs.
8, the general situation does not use antibiotics for prophylactic purposes. In particular, the abuse of broad-spectrum antibiotics, cardiovascular disease without signs of infection, cerebrovascular accidents, malignant tumors, diabetes, non-infectious shock, chronic kidney disease, generally should not be used prophylactically antibiotics.
9, all gastrointestinal surgery and gallbladder surgery in addition to other preoperative treatment, can be given 1h preoperative antibiotic prophylaxis
10.Only for patients with acute rheumatic fever, penicillin G can be used regularly to kill pharyngeal hemolytic streptococci.
11, for other elective surgery, especially cardiac surgery, intracranial surgery and bone and joint surgery, orthopedic surgery can be started 1d before surgery with antibiotics, and the use time after surgery is decided according to the condition.
12. It is important to recognize the importance of human immunity, emphasize comprehensive treatment, and not to rely too much on antibacterial drugs.
It is reported that the Ministry of Health will draft and issue the “antibacterial drug management methods for medical institutions” as soon as possible, to further clarify the person responsible for the rational use of antibiotics in medical institutions, and to clarify the hierarchical management of antibiotics, prescription reviews and other related systems. The actual antibiotics are not only a good idea, but they are also a good way to get the most out of the antibiotics.