合理使用抗生素的基本原则

合理使用抗生素的基本原则

抗生素是治疗感染性疾病的主要药物，在临床医疗工作中占有重要地位。由于抗生素种类较多，临床应用也极为广泛，其使用的合理性与患者的康复及医院的医疗质量密切相关。但近年来由于应用不合理或滥用抗生素现象日见突出，几乎成为全球问题，我国有关专家多次呼呈，合理应用抗生素已成为当务之急。为了不断总结临床应用抗生素用药中一些基本规律，使抗生素的使用达到科学合理，确保用药的安全性和有效性，更好地发挥抗生素在救死扶伤的重要作用，本文就临床上合理应用抗生素必须掌握的几个基本原则，与医药同行进行商讨。

1正确选择原则

选择抗生素治疗的前提是必须明确病因诊断，目前用药偏滥、针对性差，

主要是病因诊断做得不够造成的。正确估计致病菌，熟悉原发病的临床特点是合理应用抗生素的基础。对一些严重感染的患者，应尽一切努力寻找病原菌，在细菌培养及药敏结果未获得前，可根据病史和体格检查、病情变化和感染来源作出临床诊断，并根据临床经验选用抗生素。致病菌确定后，应根据药敏试验，及时调整抗生素。在选择抗生素时，应了解该药的抗菌作用、药代谢动力学及副作用，结合患者的具体情况选用，有条件 poverty. In the area of poverty alleviation, to rely on e-commerce business park, active docking Alibaba group "rural treasure", "the stars plan" and "featured the Museum" project to accelerate the implementation of electronic commerce "hundred thousand rural village" project, free train operation staff, offering online support help for poor families, the provision of micro-credit support, helping them to use e-commerce platform to escape

poverty. In poverty reduction, give a man a fish and feed him for a day, to targeted skills training and entrepreneurship training free of charge for the poor, increase employment, entrepreneurial skills, ensure the transfer of training people, poverty. In terms of student poverty, high school, vocational college students ' stipends and other costs, can be through the "one card", such as direct subsidies to households. In terms of financial poverty, in order to further increase the size of loans, expands the scope of delivery, developing industry, Enterprise provides protection for the poor. In respect of transport poverty alleviation, to solve the bottleneck in poor villages, development of transport, vigorously promoting the construction of rural roads and ordinary roads. PV poverty reduction, to support conditions of poor villages and photovoltaic system of centralized, poor construction projects, poor 的医院，在治疗过程中，可测定血药杀菌浓度及进行血药浓度监测，以指导

临床合理应用抗生素。总之，只有全面了解和分析机体的各种状态，从中找出抗生素应用中的一些基本规律，才能做到正确选药、合理应用、安全有效的原则。

2严格掌握适应证原则

抗生素的应用必须根据临床诊断，严格掌握适应证的原则，凡属可用可不

用的尽量不用，切忌轻率和盲目地应用。对发热病人不能见热即用抗生素，应区别病因，是病毒性感染还是细菌性感染。对已确诊为病毒感染者，除重症乙型脑炎、重症肝炎、流行性出血热、麻疹等与预防继发感染而适当用抗生素外，其他病毒感染一般不必用抗生素。

3熟悉与恰当原则

熟悉药理学及体内药物代谢动力学过程，是合理用药的基础，同时要熟悉原发病的临床特点，注意个体差异及遗传特征差异选择用药。所谓恰当是指选择适当的剂量与给药方法。用药剂量正确与否关系甚大，用量恰当能治病，用量过小达不到治疗目的，过大则会危害人体健康。因此，在临床使用抗生素时，应尽早使用，剂量要恰当，避免长期使用。特别是在肝、肾功能减退的情况下，用药要更加慎重。给药途径的不同，不仅影响药物的剂量和poverty. In the area of poverty alleviation, to rely on e-commerce business park, active docking Alibaba group "rural treasure", "the stars plan" and "featured the Museum" project to accelerate the implementation of electronic commerce "hundred thousand rural village" project, free train operation staff, offering online support help for poor families, the provision of micro-credit support, helping them to use e-commerce platform to escape poverty. In poverty reduction, give a man a fish and feed him for a day, to targeted skills training and entrepreneurship training free of charge for the poor, increase employment, entrepreneurial skills, ensure the transfer of training people, poverty. In terms of student poverty, high school, vocational college students ' stipends and other costs, can be through the "one card", such as direct subsidies to households. In terms of financial poverty, in order to further increase the size of loans, expands the scope of delivery, developing industry, Enterprise provides protection for the poor. In respect of transport poverty alleviation, to solve the bottleneck in poor villages, development of transport, vigorously promoting the construction of rural roads and ordinary roads.