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| J Korean Med Assoc > Volume 62(6); 2019 > Article |
|
Su-Mi Choi, MD1
, Dong-Gun Lee, MD1, 2
, Dong-Gun Lee, MD1, 2
Abstract
The inappropriate use of antimicrobial agents results in collateral damages such as treatment failure, an increased frequency of adverse events related to antimicrobial agents, the emergence of resistant bacteria, and increased medical costs. The selection of appropriate antimicrobial agents begins with taking a detailed history and performing a thorough physical examination to determine whether the cause of the fever is infectious or non-infectious. Based on the patient's symptoms and signs, the site of infection (a system-oriented approach) and the causative organism with high possibility (a pathogenesis-oriented approach: intracellular vs. extracellular) can be estimated. In this process, host factors, microbial factors, and the characteristics of antimicrobial agents should be considered. Herein, we summarize the recently developed Korean guidelines for the use of antimicrobial agents for infectious diseases. We also introduce the antimicrobial website and application developed by Korean Society for Antimicrobial Therapy and the antimicrobial stewardship program.
References
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Figure 1
Approaches to febrile patients (A) and general considerations in selecting appropriate antimicrobial agents (B). G (+), gram-positive organisms; G (−), gram-negative organisms; PK/PD, pharmacokinetics/pharmacodynamics; TDM, therapeutic drug monitoring.
Table 1
Organ/system-oriented approach for infectious diseases and its suggestive symptoms and signs
Table 3
Core elements of hospital antibiotic stewardship program
Adapted from Pollack LA, et al. Clin Infect Dis 2014;59 Suppl 3:S97-S100 [28].
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