Fornuftig bruk av antibiotika i sykehus [Rational use of antibiotics in hospitals].

Infeksjonsseksjonen Medisinsk klinikk Aker universitetssykehus 0514 Oslo.
Tidsskrift for den Norske laegeforening 11/2008; 128(20):2335-9.
Source: PubMed


The Norwegian antibiotic policy emphasises use of narrow-spectrum antibiotics and has been regarded as successful. We have a low occurrence of antibiotic resistance, but hospital use of antibiotics in general, and broad-spectrum antibiotics specifically, has increased substantially the last 10 years. We now see a trend towards increasing antibiotic resistance, which will inevitably lead to the same serious resistance problems in Norway as abroad.
We have assessed resistance profiles for the most common human pathogens in Norway in the light of literature retrieved through a non-systematic search of PubMed and Norwegian literature on rational antibiotic use. The article emphasises pharmacodynamic and pharmacokinetic aspects, as well as ecological side effects of antibiotics and discusses rational treatment of the most common infections in Norwegian hospitals.
Most research in this context is performed in settings with different antibiotic resistance patterns and attitudes towards antibiotic treatment than in Norway; few studies have focused on rational antibiotic use in Norwegian hospitals. We conclude that "old-fashioned" narrow-spectrum antibiotics can still be used in Norwegian hospitals, as there is little resistance to these agents.
It is still possible to treat most infections in Norwegian hospitals with narrow-spectrum antibiotics. We encourage physicians to adhere to the Norwegian antibiotic therapy tradition.

Download full-text


Available from: Jon Birger Haug
  • [Show abstract] [Hide abstract]
    ABSTRACT: Bacteroides spp. organisms, though important human commensals, are also opportunistic pathogens when they escape the colonic milieu. Resistance to multiple antibiotics has been increasing in Bacteroides spp. for decades, and is primarily due to horizontal gene transfer of a plethora of mobile elements. The mechanistic aspects of conjugation in Bacteroides spp. are only now being elucidated at a functional level. There appear to be key differences between Bacteroides spp. and non-Bacteroides spp. conjugation systems that may contribute to promiscuous gene transfer within and from this genus. This review summarizes the mechanisms of action and resistance of antibiotics used to treat Bacteroides spp. infections, and highlights current information on conjugation-based DNA exchange.
    No preview · Article · Jun 2009 · Future Microbiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: What is known and Objective There is little research on the impact of implementing and monitoring antimicrobial policy in Saudi hospitals. The purpose of this study is to measure the impact of the clinical pharmacist (CP) and infectious disease consultant (ID) interventions on the use of three antimicrobials (Caspofungin, imipenem, meropenem) in hospitalized patients in King Abdullah Medical City hospital. Methods The study was carried out in King Abdullah Medical City, in Mekkah, Saudi Arabia. The hospital is a tertiary center that provide CCU, CSICU, Cardiac, Hematology, ICU, Medical, Neuroscience, Oncology, and specialized surgery services. The use of three antimicrobials (Caspofungin, Imipenem, Meropenem) was reviewed by the clinical Pharmacist for four periods, pre and post implementation of policy. Relevant data were collected in four periods. In the first period, before policy implementing, the data were collected retrospectively to be used as baseline status reference, and in the three remaining periods that followed data were collected prospectively, and compared to base line data, to evaluate role of clinical pharmacist and ID interventions in optimizing antimicrobial therapy. Results and discussion Caspofungin duration of therapy was not affected significantly by the intervention. Statistically significant reduction in antimicrobial therapy duration was observed in imipenem (37%) and meropenem (37%) from baseline, which indicate better control on antimicrobial use and reduction in antimicrobial resistance. What is new and Conclusion The impact of the clinical pharmacist and ID interventions, in reducing antimicrobial therapy duration using imipenem and meropenem, is clear from the result presented above. However, lack of restriction and follow up in the antimicrobial policy in case of negative culture makes antimicrobial use uncontrollable in these cases. Establishing good and accepted policy may help reduce consumption and total cost of therapy.
    Full-text · Article · Feb 2014 · Saudi Pharmaceutical Journal