在资源较低的环境中实施WHO AWaRe抗生素书籍指南:老人民民主共和国的案例
Vilada Chansamouth1,2,3, Phouthavanh Inlorkham4, Bounxou Keohavong4
1Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Mahosot Hospital, Vientiane, Lao PDR.
JAC-antimicrobial resistance
|January 23, 2024
概括
世卫组织的AWaRe抗生素手册需要针对低资源环境进行更新,因为目前的建议并不完全符合老的当地传染病模式和可用的药物. 改善获取和诊断对于合理使用抗生素至关重要.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 世界卫生组织 (WHO) 在2022年出版了AWaRe (访问,观察,储备) 抗生素书,以指导合理的抗生素使用.
- 在资源较少的环境中实施全球准则存在独特的挑战.
- 老作为一个案例研究来评估AWaRe书在低收入和中等收入国家 (LMICs) 的适用性.
研究的目的:
- 审查世卫组织AWaRe抗生素书的适合性,在低资源环境中实施.
- 评估AWaRe建议与老的流行病学背景的一致性.
- 确定老合理使用抗生素的障碍和促进因素.
主要方法:
- 对老流行传染病和抗菌素敏感性模式的AWaRe建议进行比较分析.
- 在老国家基本药物清单 (NEML) 中评估抗生素的可用性和可访问性.
- 审查影响抗生素获取和使用在低资源环境中的系统因素.
主要成果:
- 在AWaRe的建议和老的疾病流行病学之间存在显著的差异 (例如,有机症,病,白病的代表性不足;Clostridioides difficile相关的腹的代表性过高).
- 在老,AWaRe推抗生素的可用性有限,没有可用的储备组抗菌剂.
- 抗生素获取的挑战包括无法获得,分布不齐,负担不起,导致不适当的使用.
结论:
- AWaRe手册可以刺激国家基本药物清单的改进,但需要更新以包括区域性重要病原体.
- 仅仅是指导方针是不够的;综合战略必须解决抗生素获取,诊断能力和管理问题.
- 将全球抗生素推与当地环境相适应,对于在LMICs有效的抗菌药物管理至关重要.
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