Assessment and Optimization of the Effects of Antibiotic Treatment in Emergency Health

Summary: The purpose of this paper is to explore methods of assessing the effectiveness of intravegetative treatment in emergency settings and to propose strategies for its optimization based on the results of the evaluation. The current state of use and problems with intra-medical antibiotics in emergency cases is revealed through the analysis of multidimensional indicators for the assessment of the effects of treatment, including clinical symptoms, laboratory examinations, microbiology tests and visual performance. It goes on to elaborate on how antibiotic treatment can be optimized in terms of precision diagnosis, rational choice of drugs, individualized drug programming and multidisciplinary collaboration to improve the success of treatment of infectious diseases in emergency medical care, reduce the abuse of antibiotics and related adverse reactions, and provide a useful reference basis for clinical practice.IntroductionEmergency internal medicine faces a wide range of infectious diseases, and the rational application of antibiotics is essential for the treatment of patients. However, there are significant differences in the effectiveness of antibiotics treatment due to the complexity and urgency of emergency cases. Accurate assessment and optimization of the effectiveness of antibiotic treatment is a key element in improving the quality of medical care in emergency cases and in ensuring the safety of patients.System of Indicators for Assessing the Impact of Intra-Emergency Antibiotic Treatment(i) Improved clinical symptoms1. Temperature changeHeat is a common symptom of many infectious diseases. The observation of the downward trend in the use of antibiotics by patients is an important basis for assessing the effectiveness of treatment. For example, in cases of pneumonia, it may be effective to indicate that antibiotics are expected to return to normal temperature within 48 – 72 hours of treatment. It should be noted, however, that changes in body temperature may not be typical in the case of certain specific pathogens (e.g., nodule streptococcus) or complications.2. Partial symptoms mitigationExamples include the reduction of cough and cough in patients with respiratory infections, the improvement of urinary frequency, urinary acuteness and urinary pain in patients with urinary infections, and the reduction of local redness and fever in patients with skin soft tissues. In the case of acute renal inflammation, the reduction of pain in the kidneys and the reduction of urine frequency and acute urination can, to some extent, reflect the inhibition of antibiotics on pathogens.(ii) Changes in laboratory inspection indicatorsGeneral blood indicatorsWhite cell count and classification are commonly used as assessment indicators. In the case of bacterial infections, the total number of white cells tends to rise and the proportion of neutral particles increases. With effective antibiotics treatment, the white cell count has gradually returned to normal range and the proportion of neutral particles has decreased. However, white cell count may not rise or even decrease at an early stage of the virus or at some specific bacterial infections (e.g. typhoid) and require a comprehensive judgement.2. C Reacting Protein (CRP) and Calcium Decorator (PCT)CRP is an acute and counterproductive protein, which rises rapidly at the time of infection and decreases when antibiotic treatment is effective. The CPT has a high level of specificity and sensitivity to bacterial infections, which are significantly elevated in the case of acute bacterial infections in the whole body and whose dynamics during treatment reflect the efficacy of antibiotics. For example, for sepsis patients, the continued decline in the PCT level presupposes that the infection is under control.(iii) Results of microbial examinations1. Pathogen culture and drug sensitivity testsPathogen culture and drug sensitivity trials before antibiotics are used are key to guiding treatment. In the course of treatment, antibiotic treatment is shown to be effective if re-planting shows a decrease in the number of pathogens or abdomen. For example, in cases of pneumococcal pneumonia, the treatment is followed by the development of pneumococcus into negative and suggests success. At the same time, the results of the drug-sensitive tests help to determine whether the selected antibiotics are sensitive and provide a basis for subsequent treatment adjustments.2. Pathogen nucleic acid detectionFor example, the PCR technology detects the nucleic acids of pathogens such as viruses, bacteria, terracites, etc. For a number of pathogens that are difficult to cultivate (e.g., paragens), nucleic acid testing can quickly determine the presence of pathogens, and reduced post-treatment nucleic acid loads can be one of the indicators for assessing the efficacy of treatment.(iv) Visual inspection performance1. Lung imagingFor patients with lung infections, chest X-line or CT examinations provide a visual indication of the extent and extent of lung pathologies. Absorption of post-pneumonia immersion is an important basis for assessing the efficacy of antibiotics. For example, in the case of pneumocococcal infections, effective treatment has led to a gradual decline in the real lung and a reduction in the scope.2. Other parts of videoThe kidney ultrasound examination, for example, monitors the improvement of kidney acupuncture and the expansion of the urine tube in the event of an infection with the urinary system; the abdominal CT examines changes in abdominal abdominal fluids and sepsis in the event of abdominal infection.III. Situation and problem analysis of intravegetal antibiotics in emergency care(i) Empirical drug limitationsEmergency physicians often select antibiotics on the basis of experience when the results of specific pathogen tests are not available. However, there are differences in the distribution of pathogens and drug resistance in different regions and hospitals, and empirical drug use may lead to inaccurate drug selection. For example, in some regions, the resistance of intestinal echella to fluorophenone-type drugs is high, but doctors continue to routinely opt for experiential treatment of this drug, which affects its effectiveness.(ii) Untimely adjustment of treatment programmesSome doctors are unable to adjust their treatment programmes in a timely manner, taking into account the changes in the patient ‘ s condition and the results of the examinations. If the patient is using antibiotics 3-5 days later, the symptoms have not significantly improved, but have not been examined further (e.g., review of pathogen culture, adjustment of antibiotics type or dosage), resulting in delays in treatment.(iii) Unreasonable joint useIn pursuit of rapid infection control, some doctors are overusing the combination of drugs. Joint drug use, however, is not always better than single-dose treatment, and unjustified joint drug use can increase the incidence of adverse drug effects and increase the financial burden on patients. For example, the use of antibiotics, which are similar to the two functioning mechanisms, not only does not improve the efficacy of treatment, but may affect the effectiveness of treatment as a result of drug interactions.IV. Strategy for optimizing the effectiveness of intra-imbiotic treatment in emergency care(i) Precision diagnosis, identification of pathogens1. Strengthening sample collection and inspection(c) Raise awareness of the importance of sample collection among emergency medical personnel and ensure that the samples collected are of sufficient quality and quantity. For example, for persons with respiratory infections, guidance should be provided on the correct retention of bathygen; for those infected with the urinary system, the collection of clean mid-ures should be carried out. At the same time, the specimens are sent for inspection in a timely manner, reducing the amount of time they are put on hold and increasing the rate of detection of pathogens.2. Rapid detection technology applicationsThe promotion of rapid microbiological detection techniques such as fluorescent in situ (FISH) and matrix-aided laser desorption time mass spectrometers (MALDI – TOF MS) can be used in a short period of time to identify pathogens and provide a basis for precision medicine. For example, MALDI – TOF MS can identify common pathogens within hours, significantly reducing the time for diagnosis.(ii) Optimization of drug selection based on pharmacological tests and pharmacokinetics/pharmacology (PK/PD)1. Focus on drug-sensitive test resultsSelect sensitive antibiotics based on the results of sensitive tests and avoid the use of drug-resistant antibiotics. For multi-drug-resistant infections, targeted combinations of antibiotics or new types of antibacterial drugs can be selected using relevant national and international guidelines and expert consensus. In the case of the Metoxysilin-yellow fungus (MRSA) infection, the option is to use Vancomicin, Linazine, etc.2. Consideration of PK/PD characteristicsThe PK/PD properties of different antibiotics vary, e.g. time-dependent antibiotics (e.g. β-neamide) need to ensure that the concentration of the drug in the body is long enough to remain above the lowest antibacterial concentration (MIC); concentrations of dependent antibiotics (e.g. carbamate sluice) need to reach a high hemopharmaceutical peak. The development of a rational delivery programme based on the PK/PD characteristics of antibiotics, such as the adjustment of the dose, time interval, etc., can increase the efficacy of treatment and reduce adverse effects.(iii) Development of individualized treatment programmes1. Consideration of patient factorsA combination of age, underlying illness, liver and kidney function and immunisation status of the patient is taken into account. For elderly patients, due to the reduction of liver and kidney function, drug metabolism and excretion, appropriate adjustments should be made to the doses of antibiotics; for patients with low immune functions, such as AIDS patients, oncological patients receiving chemotherapy, the infection is spread-prone and the pathogen is likely to be special, with the choice of strong, broad-scale and less reactive antibiotics and increased support for treatment.2. Dynamic assessment and adjustmentIn the course of antibiotics treatment, changes in the patient ‘ s condition, laboratory examination indicators and visual performance are monitored on an ongoing basis and treatment programmes are adjusted in a timely manner based on the results of the assessment. In cases where the patient has absconded at the beginning of treatment but has subsequently increased, the availability of pathogen resistance, combination of other infections or complications should be reassessed, and antibiotics replaced or treatment strategies adapted in a timely manner.(iv) Enhanced multidisciplinary collaboration1. Collaboration between emergency internal medicine and microbiology laboratoriesMicrobiology laboratories provide timely feedback on pathogen culture and drug-sensitization tests to the emergency internal section and provide specialized microbial advice. The emergency internal physician communicates regularly with the technicians of the microbiology laboratory to explore the detection methods and treatment strategies of the pathogen in the case at hand. For example, for some pathogen infections that are difficult to cultivate, the parties cooperate to optimize the testing process and increase the detection rate.2. Cooperation with pharmacological departmentsThe pharmacology department arranges for the participation of clinical pharmacists in the antibiotic treatment process in emergency internal medicine. Clinical pharmacists assist doctors in developing rational drug use programmes and provide professional guidance on drug selection, dosage adjustment, interaction, etc. For example, when patients are using multiple drugs at the same time, clinical pharmacists assess the interaction between drugs to avoid affecting antibiotics or increasing the risk of adverse reactions; and accurately calculate and adjust the dose of drugs for specific populations (e.g. children, pregnant women, the elderly).ConclusionsThe assessment and optimization of the effectiveness of intra-medical antibiotics treatment is a complex and systematic project. By establishing a comprehensive and scientific system of indicators of assessment, in-depth analysis of the current treatment situation and problems, and the adoption of optimal strategies such as precision diagnosis, rational choice of drugs, individualized treatment and multidisciplinary collaboration, it will be possible to increase the effectiveness of antibiotic treatments, reduce the abuse of antibiotics and related adverse effects, provide better protection for the treatment of patients with infectious diseases in emergency medical care, and promote a higher level of rational use of antibiotics in emergency medical care.