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The last 20 to 30 years, the rapid spread of antimicrobial drug resistance phenomenon, not just a clinical treatment of a major difficult issues, but also become a major microbial ecology and public health threat. Resistance to existing antibiotics times better application almost as a historical mission. Antibiotic pharmacokinetics (PK) pharmacodynamic integration (PD) that PK / PD study largely assumed this mission and made important progress. In recent days by the Chinese Pharmaceutical Association Antibiotic Professional Committee of the Eleventh National antibiotics (microbial agents) academic session, Zhongshan Hospital, Fudan University Professor He Lixian emphasized the optimization of antibiotic resistance in the treatment time is essential, and introduced the optimal antibiotic treatment of several clinical strategies to achieve as much as possible in the clinical treatment of the purpose of efficient and low resistance. According to Ho Lai Yin introduction of antibiotics in developed countries under very strict control. Instead of waiting for etiological diagnosis of clear selection after starting antibiotic sensitive or specific treatment, but since the 90s of last century, many studies have shown that a significant delay in antibiotic treatment affect the prognosis. Community-acquired pneumonia, for example, from patients to hospital for treatment to an antimicrobial drug use, time of more than 8 hours shorter in the 8-hour mortality rate was significantly higher. Later studies show that starting antibiotic therapy should be less than 4 hours time. Severe sepsis and septic shock in clinical diagnosis should be within 1 hour after the start empirical antibiotic treatment. In addition to empirical treatment to begin as early as possible also requires broad-spectrum, covering at least the first 3 ~ 4 major pathogens. Before the start of antibiotic treatment must retain an etiological diagnostic specimens, and the timely delivery and vaccination. Empirical or specific targeted therapy is not strong, you need 48 to 72 hours after the pathogen diagnostic report, combined with clinical response to re-evaluate a condition. If the etiological diagnosis of high specificity or to confirm the diagnosis, we can be the first broad-spectrum treatment targeted to a narrow spectrum antibiotics. "This is the so-called escalation therapy, also known as the streamlined treatment." Ho Lai Yin said, the treatment strategy of escalation, particularly suitable for severe infection or major, is the use of broad-spectrum combination therapy to improve prognosis and to avoid broad-spectrum antimicrobial drug resistance and drug use as short as possible time between the current find a balance or compromise, is also based on etiological diagnosis of the current time lag taken by a two-stage anti-infective treatment (therapy and targeted therapy experience) design. Current escalation therapy in practice, some people mistakenly escalation therapy strategies and the current antimicrobial drug use policies introduced in opposition, afraid to use. Which he believes that a time lag antibiotics or rigid policy may exist, but a long-term point of view they are not contradictory, it is important to use the power of science and more in-depth research to influence policy makers. Early 70s of last century, because the gentamicin resistance rate of rise, and began cycling amikacin and gentamicin (rotation) used in this study, the results less consistent. Since the 80s of last century, there have been many in the ICU implementation of the loop on medication strategy. He introduced Bruce Road, reported in France in 2003, pellegrin University Hospital since 1996, seven years in ventilator-associated pneumonia (VAP) in the implementation of the cycle of drug treatment of early-onset VAP (<7 days) by amoxicillin / clarithromycin dimensional acid, Cephalosporin Cefotaxime, ceftriaxone, cefpirome monthly rotation of the order; on the late onset VAP (> 7 days) according to cefepime, piperacillin / tazobactam, imipenem, ticarcillin / clavulanic acid, ceftazidime monthly rotation of the order of the results the incidence of VAP from 23% to 16.3% (statistically significant), late-onset VAP in patients with G-bacilli to antimicrobial drugs, especially piperacillin / tazobactam and cefepime sensitivity improvement. Ho Lai Yin said the drug could reduce the resistance on the cycle rate, there are many reports of negative results, so controversial. In practice, the cycle loop medication, drug selection and order of rotation, resistant Pharmaceutical Machine The same system, the arrangements and many different varieties currently unable to answer questions. For the most recent cycle of drug use tend to hold negative attitudes, but the American Thoracic Society and the Infectious Diseases Society of jointly developed in 2005, "Hospital-acquired pneumonia guidelines" that the strategy met the department's diversity, you can spread antibiotic selective pressure. The e-commerce company in China offers quality products such as China uninterruptible power supply , China ups 3 phase, and more. For more , please visit online uninterruptible power supply today!
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