In principle, antimicrobials should not be used prophylactically

There are no bacteria, fungi.

When infected with pathogenic microorganisms such as chlamydia, specific diseases such as colds, gouty arthritis, rheumatoid arthritis, viral pneumonia, and non-Helicobacter pylori infection.

Chronic gastritis, peptic ulcers, and some superficial surgical operations do not require routine prophylaxis of antimicrobial drugs.

The principles of perioperative antimicrobial prophylaxis are generally as follows: 1. For a class of clean wounds, such as thyroid and breast.

In principle, antimicrobial prophylaxis is not recommended for surgery such as saphenous vein. However, cephalosporin may be given if the patient is older than 75 years and has a preoperative comorbid condition such as chronic lung infection.

Second-generation anti-infective**. 2. For the second type of incision, such as laparoscopic appendectomy, laparoscopic gallbladder resection, laparoscopic gastric cancer.

** and other surgeries, prophylactic anti-infective drugs are mostly administered within 30 minutes before surgery. If the procedure lasts more than 3 hours, an additional set of antibiotics is required during the procedure. Antimicrobial drugs should be stopped more than 24 hours after the end of surgery.

3. In principle, the prophylactic medication should not exceed 48 hours, and if the patient's postoperative blood examination shows white blood cells.

Persistently elevated, chills.

For symptoms such as high fever, it is recommended to choose a sensitive antibiotic to fight the infection based on the results of the patient's blood and pus cultures**. Antimicrobial drugs play an important role in the prevention and control of surgical infections. Due to antibiotics.

There are many types and wide applications, and abuse occurs from time to time. The principle of perioperative antimicrobial prophylaxis is that prophylactic antimicrobial drugs are usually not required for clean surgery, such as saphenous varicose veins and inguinal hernia surgery.

For clean and contaminated surgery, there is a large number of human parasites in the surgical site, which may contaminate the surgical field during surgery and cause infection, so it is necessary to use antibiotics for prevention, such as gastrointestinal and urinary tract surgery. For contaminated surgery, antibiotics should be used prophylactically, such as gastric perforation and open trauma.

First of all, it is necessary to clarify the definition of cleaning (incision-like) in the basic principles of antimicrobial application: organs are sterile parts of the human body, with no local inflammation or damage, and do not involve organs that communicate between the human body and the outside world, such as the respiratory tract, digestive tract, and genitourinary tract. There is no contamination in the area, and antimicrobial prophylaxis is usually not required.

Therefore, in principle, it is not recommended to prevent the use of antimicrobials for transbody surface incisions, such as thyroid resection, tumor resection, and body surface mass resection, unless there is already an infection foci at the incision.

In addition, prevention can be considered in the following situations: large range, long time, increased chance of contamination; Involving important organs, once the infection occurs, it will cause serious consequences, such as the head, heart, etc.; Foreign body implantation, such as artificial heart valve implantation, permanent pacemaker placement, artificial joint replacement, etc.; Patients with high-risk factors for infection, such as advanced age, diabetes, immunocompromised (especially those who have received organ transplants), malnutrition, etc.

What does not conform to the principle of rational use of antimicrobials is: antibiotics are used for virus ** infection.

The irrational application of antimicrobial drugs is manifested in many aspects, such as: unindicated prophylactic drugs, unindicated ** drugs, wrong selection of antimicrobial varieties and doses, unreasonable route of administration, number of administrations and course of treatment, etc.

The ideal antimicrobial agent should have the ability to interfere with the important functions of the bacteria without affecting the properties of the host cell. When developing antimicrobial drugs, scientists try to improve the selectivity of the drug against pathogens and reduce its toxicity to the host. When using antimicrobials, it is necessary to pay attention to restoring and improving the host's own defense function and give full play to the best effect of the drug.

There are also many irrationalities in the management of antimicrobial drugs: it is manifested in the liberalization of antimicrobial drug sales and the distortion of hospital operation mechanism, the lack of management and supervision in the application of antimicrobial drugs in hospitals, the lack of effective administrative and technical interventions, and the lack of clear management responsibilities, resulting in the lack of regulatory functions in relevant departments (medical department, nosocomial infection department, and pharmacy department).

When selecting antimicrobial drugs, it is necessary to consider the type of microorganisms infected by the patient, the state of the patient, the antibacterial effect of the drug, the antibacterial spectrum, the selectivity of the antimicrobial function and the impact on the body.

The selection of antimicrobial agents should first clarify the clinical indications of the patient, identify the pathogen causing the infection, and select antimicrobial drugs with high efficacy and low toxicity**.

The selection of antimicrobial agents should first clarify the patient's clinical indications. Identify the causative agent causing the infection (preferably with bacteriological diagnosis and in vitro susceptibility testing) and select antimicrobial agents with high efficacy and low toxicity**.

If unidentified, a combination of drugs or broad-spectrum antimicrobials is often used. In addition, the antimicrobial activity, pharmacokinetic characteristics, adverse reactions and economy of antimicrobial drugs should also be considered. The prophylactic use of antimicrobial drugs should also be strictly indicated to prevent drug abuse.

Prophylactic use is limited to a few cases, such as burns, prevention of sepsis, prevention of ophthalmia in newborns, prevention of transmission during epidemic diseases, etc.

Antimicrobial drugs are mainly used for diseases caused by bacterial infections, and are not effective against various viral infections, such as influenza, and it is not necessary to use conventional antimicrobial drugs.

Rational use and progress of antimicrobial drugs1. Rational use of antibiotics.

Appropriate antimicrobials should be used as clearly indicated, and appropriate doses and courses of treatment should be used to achieve killing.

pathogenic bacteria, control infection, and take various corresponding measures to enhance the patient's immunity and prevent malpractice.

reactions, especially to avoid the development of bacterial resistance.

2. Aspects of irrational use of antimicrobials:

Use drugs that are ineffective and ineffective against pathogenic bacteria or infections; insufficient or excessive amounts; continue to use the drug after the pathogen develops resistance; Discontinuation of the drug prematurely or failure to stop the drug in time after infection control for many days; Failure to switch to other effective drugs when superinfection with drug-resistant bacteria occurs; Incorrect route of administration; Continue to take the drug in the event of a severe or allergic reaction; inappropriate combination of antimicrobials; reliance on the antimicrobial effects of antimicrobials to the neglect of necessary surgical management; prophylaxis for which no or no indication is given; Ignoring the efficacy **than.

3. Problems involved in the rational use of drugs:

Indications for the use of antimicrobials and combinations; pharmacokinetics and pharmacodynamics of antimicrobials; Experience in anti-infective medications; the dose, duration and method of administration of antimicrobials; adverse reactions and prevention of antimicrobials; changes and prevention of bacterial resistance; the application of antimicrobials in special cases, etc.

4. Basic principles of antimicrobial application:

1 Early identification of the etiological diagnosis of infectious diseases.

2. Familiar with the indications, antibacterial activity, pharmacokinetics and adverse reactions of the selected drugs.

3. Rational use of drugs according to the physiological, pathological and immune status of the patient.

4 Rational use of commonly used antimicrobials.

5 Select the appropriate dosing regimen, dosage and course of treatment.

6. The application of antibiotics should be strictly controlled or avoided as much as possible in the following situations: preventive medication, local medication of mucous membranes; Viral infection or fever with unknown cause; Antimicrobial drugs are used in combination.

7. Emphasizing the importance of a comprehensive ** approach;

Summary. The indications for prophylactic use of antibiotics mainly include contaminated surgical incisions and organ transplant surgery, but they also need to be used under the guidance of a doctor, and should not be used blindly. 1. The surgical incision is contaminated

The main purpose of antibiotic prophylaxis is to prevent infection during the procedure and is indicated for symptoms of contaminated surgical incisions, such as cuts or trauma. 2. Organ transplantation: The operation time of organ transplantation surgery is relatively long and the scope is large, so prophylactic antibiotics should be used in advance to avoid infection during surgical suturing and prevent the appearance of diseases.

The indications for the prophylactic use of antibiotics mainly include contaminated surgical incisions and organ transplant surgery, but they also need to be used under the guidance of a doctor. 1. Contamination of the surgical incision: The purpose of prophylactic use of antibiotics is mainly to avoid infection during the operation, and it is suitable for the symptoms of contaminated surgical incision, such as knife cuts or trauma.

2. Organ transplantation: The operation time of organ transplantation is relatively long and the scope is large, so preventive antibiotics should be used in advance to avoid infection and prevent the appearance of diseases during surgical sutures.

What else are there, that's the title.

Are these two cases the only one?

1. Internal medicine and pediatric prophylactic medication 1It may be effective in preventing infections caused by the invasion of one or two specific pathogens into the body; If the aim is to prevent any bacterial invasion, it is often ineffective. 2.

Prevention of infections that occur over a period of time may be effective; Long-term prophylactic medication often fails to achieve the goal. 3.If the patient's primary disease can be ** or in remission, pre-hail prevention drugs may be effective.

For those whose primary disease cannot be ** or relieved (such as immunodeficient), prophylactic drugs should be avoided or used sparingly. For immunocompromised patients, it is advisable to closely observe their condition, and once signs of infection appear, experience should be given first at the same time as the relevant specimens are sent for culture. 4.

It is usually not suitable for routine prophylactic use of antimicrobial drugs: common cold, measles, chickenpox and other viral diseases, coma, shock, poisoning, heart failure, tumors, adrenocorticosteroids and other patients. 2. Surgical prophylaxis (1) Purpose of surgical prophylaxis:

Prevention of post-operative incision infections, as well as clean-contaminated or contaminated post-operative surgical site infections and systemic ** infections that may occur after surgery. (2) The basic principle of prophylactic medication in surgery: according to whether the surgical field is contaminated or may be contaminated, decide whether to use antimicrobial drugs for prophylaxis.

1.Clean surgery: The surgical field is a sterile part of the human body, with no local inflammation or damage, and does not involve organs that communicate with the outside world, such as the respiratory tract, digestive tract, and genitourinary tract.

There is no contamination of the surgical field, and prophylactic antimicrobial drugs are usually not required, and prophylactic drugs can only be considered in the following cases: (1) hand.