REVIEWS   

Minerva Pneumologica 2016 December;55(4):94-105

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Biomarkers and rapid diagnostics in antibiotic stewardship

Eleni PAPAKONSTANTINOU, Daiana STOLZ

Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital, Basel, Switzerland

Antimicrobial stewardship is an important strategy to limit the emergence of antibiotic resistance, prolong the effective use of antibiotics, improve patient outcomes, decrease adverse consequences such as adverse drug reactions and antimicrobial-associated infections and deliver cost-effective therapy. It refers to the liable use of antimicrobials by healthcare professionals regarding the appropriate selection of antibiotics, duration of treatment, dosage, and route of administration for each patient with a suspected infection. The present review aims to highlight the problems that rise from antibiotics overuse and/or misuse and discuss the principles for antibiotic stewardship in the community. Since lower respiratory tract infections are the most common reason for antibiotic prescription worldwide, this review focuses on rapid diagnostics and biomarkers that could help the physicians to distinguish between acute bronchitis and pneumonia. This apparently simple decision turns to be challenging in the routine care of patients with LRTI. Importantly, while bronchitis is self-limiting and there is not a meaningful benefit from antibiotic treatment, pneumonia tends to be a severe infection, mostly with a bacterial origin, with high risk for complications thus requiring antibiotic treatment and close monitoring.