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1、Insert Name of presenter Insert Name of hospital,Using antibiotics prudently,- Hospital Prescriber Presentation,Contents of this presentation,Antibiotic resistance a patient safety issue Situation in Europe Drivers of antibiotic resistance Consequences of antibiotic resistance Why inappropriate use
2、of antibiotics contributes to antibiotic resistance the “why” How prudent use of antibiotics can be promoted in hospitals the “how” European Antibiotic Awareness Day a campaign to promote prudent use of antibiotics,2,Antibiotic resistance a patient safety issue,3,Antibiotic resistance a problem in t
3、he present and the future,Antibiotic resistance is an increasingly serious public health problem: resistant bacteria have become an everyday concern in hospitals across Europe.,4,Trends in antibiotic resistance (invasive infections), 2002-2008. Source: European Antimicrobial Resistance Surveillance
4、System (EARSS), 2009.,2002 2007,Methicillin-resistant Staphylococcus aureus (MRSA), blood and spinal fluid,Source: European Antimicrobial Resistance Surveillance System (EARSS), 2008.,5,Methicillin-resistant Staphylococcus aureus (MRSA), EU, 2007: often high, but decreasing in many countries, Countr
5、y with a significant increase (20052007) Country with a significant decrease (20052007),MRSA (%),Source: EARSS & ECDC, 2009,No. of countries,6,Antimicrobial resistance in gram-negative bacteria, EU, 2007: already high or increasing,Country with a significant increase (2005-2007) Country with a signi
6、ficant decrease (2005-2007),Carbapenem-resistant Pseudomonas aeruginosa (%),3rd-gen. ceph.-resistant Klebsiella pneumoniae (%),3rd-gen. ceph.-resistant Escherichia coli (%),Source: EARSS & ECDC, 2009,No. of countries,No. of countries,7,Source: European Surveillance of Antimicrobial Consumption (ESAC
7、), 2010. In: ECDC Annual Epidemiological Report 2010: in press.,Total outpatient antibiotic use in EU Member States, Iceland and Norway, 2008,8,* Total use, i.e. including inpatients (CY, GR, LT). * Reimbursement data, i.e. not including over-the-counter sales without a prescription (ES) * Data from
8、 2007 (MT),Antibiotic resistance A patient safety issue for all hospitals,The emergence, selection and spread of resistant bacteria in hospitals is a major patient safety issue. Infections with antibiotic-resistant bacteria can result in increased patient morbidity and mortality, as well as increase
9、d hospital length of stay.1-2 Antibiotic resistance frequently leads to a delay in appropriate antibiotic therapy.3 Inappropriate or delayed antibiotic therapy in patients with severe infections is associated with worse patient outcomes and sometimes death.4-6,9,1. Cosgrove SE, Carmeli Y. The impact
10、 of antimicrobial resistance on health and economic outcomes. Clin Infect Dis. 2003 Jun 1;36(11):1433-7. 2. Roberts RR, Hota B, Ahmad I, Scott RD, 2nd, Foster SD, Abbasi F, et al. Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: implications for antib
11、iotic stewardship. Clin Infect Dis. 2009 Oct 15;49(8):1175-84. 3. Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest. 1999 Feb;115(2):462-74. 4. Ibrahim EH, Sherman G, Ward S, Fraser VJ,
12、 Kollef MH. The influence of inadequate antimicrobial treatment of bloodstream infections on patient outcomes in the ICU setting. Chest. 2000 Jul;118(1):146-55. 5. Lodise TP, McKinnon PS, Swiderski L, Rybak MJ. Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus au
13、reus bacteremia. Clin Infect Dis. 2003 Jun 1;36(11):1418-23. 6. Alvarez-Lerma F. Modification of empiric antibiotic treatment in patients with pneumonia acquired in the intensive care unit. ICU-Acquired neumonia Study Group. Intensive Care Med. 1996 May;22(5):387-94.,Antibiotic resistance a daily oc
14、currence in our hospital,In our country / hospital the most frequent resistant infections are the following insert appropriate data where available. These infections have resulted in insert data on additional days of hospitalisation, morbidity, mortality, and costs where available.,10,Why inappropri
15、ate use of antibiotics contributes to antibiotic resistance the “why”,11,In-patients are at high risk of antibiotic-resistant infections,Misuse of antibiotics in hospitals is one of the main factors that drive development of antibiotic resistance.7-9 Patients in hospitals have a high probability of
16、receiving an antibiotic10 and 50% adapt to national figure where available of all antibiotic use in hospitals can be inappropriate.11-12,12,7. Singh N, Yu VL. Rational empiric antibiotic prescription in the ICU. Chest. 2000 May;117(5):1496-9. 8. Lesch CA, Itokazu GS, Danziger LH, Weinstein RA. Multi
17、-hospital analysis of antimicrobial usage and resistance trends. Diagn Microbiol Infect Dis. 2001 Nov;41(3):149-54. 9. Lepper PM, Grusa E, Reichl H, Hogel J, Trautmann M. Consumption of imipenem correlates with beta-lactam resistance in Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2002 Sep;4
18、6(9):2920-5. 10. Ansari F, Erntell M, Goossens H, Davey P. The European surveillance of antimicrobial consumption (ESAC) point-prevalence survey of antibacterial use in 20 European hospitals in 2006. Clin Infect Dis. 2009 Nov 15;49(10):1496-504. 11. Davey P, Brown E, Fenelon L, Finch R, Gould I, Har
19、tman G, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2005(4):CD003543. 12. Willemsen I, Groenhuijzen A, Bogaers D, Stuurman A, van Keulen P, Kluytmans J. Appropriateness of antimicrobial therapy measured by repeated prevalence surveys. Antimicrob Agents Chemother. 2007 Mar;51(3):864-7.,
