Introduction
In the modern health care system, level-III hospitals have complex and difficult medical tasks and the use of antibiotics is very frequent. However, the increasing problem of drug-resistant bacteria caused by the irrational use of antibiotics threatens global public health security. As a result, the management of antibiotics in level III hospitals is essential, as it is central to the quality of care, patient safety and response to drug-resistant crises.
II. Status and problems with antibiotics in tertiary hospitals
(i) Extensive and complex use
Patients in level III hospitals tend to be more serious and complex and involve multisystem diseases. For example, in the ICU, patients may suffer from multiple infectious diseases, such as lung and urinary system infections, or undergo large-scale operations requiring treatment and prevention of infection using a variety of antibiotics. In addition, oncological patients are vulnerable to infection during chemotherapy due to low immunity and are more dependent on antibiotics.
(ii) Unreasonable use
1. Overuse: In order to prevent possible infections, some doctors use antibiotics without clear instructions. For example, some clean-up operations, such as thyroid surgery, which would not have required the preventive use of antibiotics, are still used in some cases, increasing the risk of unnecessary medication and medical costs for patients.
2. Inappropriate selection: Antibiotics are not selected according to pathogen type and pharmacological test results. In the treatment of lung infections, there may be no distinction between gland positive and gland cactus infections, and blind use of antibiotics leads to poor treatment and delays.
3. The treatment process is unreasonable: some doctors stop the drug too soon after the patient ‘ s symptoms have abated, leading to a relapse into the infection, while others extend the course of antibiotic use without the need to do so, increasing the probability of a drug-resistant bacteria.
III. Antibiotic management measures at level III hospitals
(i) Establishment of rigorous management organizations and systems
Level III hospitals should establish antibiotics management teams with multidisciplinary experts in the infectious, pharmacological and clinical sections. A range of regulations have been developed, including a regime for the classification of antibiotics, guidelines for their use, and a system for the review of prescriptions. For example, antibiotics are divided into three levels of non-restricted, restricted and special use, with different levels of prescription for different levels of doctors, and special use of a class of antibiotics is subject to expert consultation.
(ii) Enhanced education and training
Continuous training of health-care personnel on antibiotics, including pharmacological knowledge, clinical application guidelines, and the state of drug resistance. Regular lectures, case analysis discussions, etc. are held to raise the awareness and capacity of health-care personnel to rationally use antibiotics. For example, through a practical case analysis, doctors are made aware of the consequences of the irrational use of antibiotics, leading to the deterioration of the patient ‘ s condition, and their sense of responsibility to regulate the use of medicines is increased.
(iii) Normative review and monitoring of prescriptions
1. Pre-prescription review: real-time review of the use of antibiotics when prescribed by a physician, using an information system. If unreasonable use is found, e.g., a dose error, an adjustment certificate, etc., the system alerts the doctor in a timely manner.
2. Use of monitoring and feedback: Establish a monitoring system for the use of antibiotics, regularly statistically analyse data on the type, dosage, rate of use of antibiotics in the various sections and provide feedback to the sections. Focus and intervention on the use of unreasonable sections. For example, if the rate of antibiotics in a particular section is significantly higher than the average for the entire compound, the management team will go into the section to investigate and provide guidance.
(iv) Strengthening of microbiology laboratories
Improving microbiological detection techniques to improve the efficiency and accuracy of detection of pathogens. Quick and accurate delivery of the results of the drug-sensitive trials to the clinical community to guide doctors in the rational selection of antibiotics. For example, the use of advanced molecular biology tests has made it possible to identify pathogen strains more quickly and to reduce the duration of the tests so that patients receive timely and accurate treatment.
IV. Meaning of antibiotics management in tertiary hospitals
(i) Improved quality of care
Rational use of antibiotics increases the cure rate for infectious diseases and reduces the incidence of complications. For example, in the treatment of bacterial endocarditis, the correct choice and use of antibiotics can effectively remove pathogens, reduce the incidence of serious complications such as heart valve damage and improve patient prognosis.
(ii) Controlling the spread of resistant bacteria
Normative antibiotics management can reduce the production and spread of drug-resistant bacteria. When antibiotics are used rationally, the pressure for bacterial resistance is reduced, helping to maintain the effectiveness of existing antibiotics, to ensure the safety of the medical environment and to avoid serious public health problems such as superbacterials.
(iii) Reduced medical costs
Reducing the needless use of antibiotics reduces the cost of medical care for patients, while reducing the burden on health care and society. For example, the avoidance of overuse of expensive, special-grade antibiotics, the rational choice of medicines at higher prices and a more rational distribution of medical resources.
Conclusions
Antibiotic management in level III hospitals is a systematic and challenging task that relates to the quality of care, patient safety and public health. Through sound management organizations and systems, continuous education, rigorous prescription and monitoring, and strong microbiological laboratory support, level III hospitals are able to achieve rational use of antibiotics, effectively respond to drug resistance challenges and provide better quality, safe and economical medical care for patients.
