在欧洲地区高风险国家滥用和过度使用抗生素的决定因素:多学科的德尔菲研究
Bahar Madran1,2, Francisco Almeida3,4,5, Elena Carrara6
1Department of Public Health, School of Medicine, Koç University, Istanbul, Türkiye.
概括
抗菌素耐药性 (AMR) 是一个日益增长的威胁. 这项研究确定了门诊环境中不适当使用抗生素的关键原因,并为希腊,意大利,葡萄牙和土耳其等高风险国家提出了专家驱动的解决方案.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 卫生政策 卫生政策
背景情况:
- 抗菌素耐药性 (AMR) 构成了全球健康的重大威胁,预计到2050年在南欧和地中海国家产生很大的影响.
- 门诊抗生素的滥用和过度使用是AMR的主要驱动因素,需要有针对性的干预措施.
研究的目的:
- 为了确定在门诊环境中不适当的抗生素处方的根本原因.
- 开发特定于环境的,专家驱动的解决方案,以减轻高风险国家中的抗药性抵抗.
主要方法:
- 两轮的e-Delphi过程涉及来自希腊,意大利,葡萄牙和土耳其的109名专家.
- 使用7点的利克特度量表来评估47个潜在的原因和25个建议的解决方案.
- 由四分位数范围,中位数和百分比协议定义的共识;使用肯德尔的W.W.评估的专家协议.
主要成果:
- 在不适当使用抗生素的6个主要原因和21个有效解决方案上达成共识.
- 确定了患者因素 (低健康素养,抗药性意识,康复期望) 和系统层面的问题 (监管薄弱,资金不足的管理) 作为主要贡献者.
- 优先解决方案包括对非处方抗生素进行更严格的监管,更新的指南和临床决策支持工具.
结论:
- 打击抗菌耐药性需要综合战略,解决系统性改革和个人行为变化.
- 考虑到诸如医疗保健的可访问性和医生与患者之间的沟通等因素,量身定制的国家方法至关重要.
- 对环境敏感的策略和分享最佳实践对于有效的全球抗菌药物耐药性制至关重要.
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