ELRC project Acquisition of bilingual data (from multilingual websites), normalization, cleaning, deduplication and identification of parallel documents have been done by ILSP-FC tool. Multilingual embeddings -based approach was adopted for alignment of segments. Merging/filtering of segment pairs has also been applied. en sl 985 15847 16650 3533 2368

1.5 Razvrsti po: Sort by: 1.4 Uporabi Apply 0.7575757575757576 EVROPSKI DAN ANTIBIOTIKOV European Antibiotic Awareness Day 1.588235294117647 Remove this filter Audience: zdravstveni delavci v primarnem zdravstvenem varstvu Remove this filter Audience: primary care providers 1.5238095238095237 Povzetek dejstev za strokovnjake Factsheet for experts 1.035 Z grafičnim prikazom so pojasnjeni postopek odpornosti proti antibiotikom, razmerje med uporabo antibiotikov in odpornostjo proti mikrobom ter nedavni trend vse večje odpornosti proti rezervnim antibiotikom. Infographics explaining the process of antibiotic resistance, the relation between antibiotic consumption and antimicrobial resistance, the recent trend of growing resistance to last-line antibiotics. 1.5 Osnovni podatki Factsheets 0.5185185185185185 Odpornost na protimikrobna zdravila je sposobnost mikroorganizma (npr. Antimicrobial resistance is the ability of a microorganism (e.g., a bacterium, a virus) to resist the action of an antimicrobial agent. 0.7708333333333334 povzročitelja malarije), da je odporen na učinke protimikrobnega zdravila. The major cause of antimicrobial resistance remains the use of antimicrobials in human medicine. 1.0285714285714285 Ključna sporočila za splošno javnost Key messages for the general public 1.390625 Lill-Karin iz Norveške se je okužila z bakterijo, odporno na številne antibiotike, ko se je zaradi nesreče v tujini, kjer je bila na počitnicah, zdravila v tamkajšnji bolnišnici. Lill-Karin, Norway, caught bacteria resistant to many antibiotics after an accident and a hospitay stay while on holiday abroad. 0.9861111111111112 Samozdravljenje z antibiotiki je neodgovoren način uporabe antibiotikov Self-medication with antibiotics is not a responsible use of antibiotics 0.9197860962566845 Bakterija, ki so jo osamili iz Mohammedovega krvnega obtoka, je bila odporna na številne antibiotike, vključno na antibiotike zadnje obrambne linije, imenovane karbapenemi. The bacterium that was isolated from Mohammed's bloodstream was resistant to many antibiotics, including the last-source antibiotics - a class of last-line antibiotics called carbapenems. 1.2702702702702702 Glavna opozorila za predpisovalce v bolnišnicah Key messages for hospital prescribers 0.9710144927536232 Samozdravljenje z antibiotiki: Ključna sporočila za splošno javnost Key messages for the general public: Self-medication with antibiotics 1.5121951219512195 Ključna sporočila za zdravstvene delavce v primarnem zdravstvu Key messages for primary care prescribers 0.8571428571428571 EAAD v družbenih medijih ECDC patient story: Mohammed 1.6 slovenščina (sl) Media type 1.0333333333333334 Remove this filter Audience: Zdravstveni delavci v bolnišnicah Remove this filter Audience: healthcare workers in hospitals 1.0606060606060606 EVROPSKA POBUDA NA PODROCJU ZDRAVJA European Antibiotic Awareness Day 0.92 Remove this filter Audience: splošni zdravniki Remove this filter Audience: general practitioners 1.4313725490196079 ključna sporočila, informativno gradivo, komplet informativnega gradiva - factsheet, information material, toolkit material - 1.3571428571428572 Predloga dopisa za nacionalne organe javnega zdravstva, ki se pošlje predpisovalcem zdravil v primarnem zdravstvenem varstvu za predstavitev kampanje evropski dan ozaveščanja o antibiotikih. A template letter for national public health authorities to send to primary care prescribers to introduce European Antibiotic Awareness Day. 1.050561797752809 Brošura, ki jo zdravniki v osnovnem zdravstvenem varstvu izročijo bolnikom: v njej je pojasnjeno, kaj odpornost proti antibiotikom je in zakaj je ustrezna raba antibiotikov tako pomembna. A patient leaflet for primary care prescribers to hand out to patients: it explains to patients what antibiotic resistance is and why appropriate use of antibiotics is important. 1.1733333333333333 Primer pogovora z bolnikom, ki temelji na razpoložljivih dokazih, je lahko v pomoč zdravnikom, ki predpisujejo zdravila v osnovnem zdravstvenem varstvu in se srečujejo s pritiski bolnikov, ki zahtevajo antibiotike, bolnike pa spodbuja k ustrezni rabi antibiotikov. A model for a patient dialogue on the basis of available evidence provides guidance and support for primary care prescribers who encounter patient pressure for antibiotics, and promotes appropriate antibiotic use by patients. 1.368421052631579 informativno gradivo, komplet informativnega gradiva information material, toolkit material 1.25 Osnovni podatki Infographics 1.5671641791044777 Zdravniki, ki predpisujejo zdravila v osnovnem zdravstvenem varstvu, bodo v povzetku dejstev o odpornosti proti antibiotikom našli podatke o najnovejših gibanjih na tem področju na ravni EU in posameznih držav. A factsheet on antibiotic resistance in primary care provides primary care prescribers with EU and national data on the latest trends. 1.1981981981981982 Povzetek dejstev o pojavu in naraščanju odpornosti proti antibiotikom v zdravstvenih zavodih ter načinih za spopadanje s tem pojavom. Factsheet on the emergence and rise of antibiotic resistance in hospital settings and ways to fight this trend. 1.1304347826086956 informativno gradivo, komplet informativnega gradiva information material, poster, toolkit material 0.6 Seznam Media type 0.6176470588235294 Seznam ima obliko kartončka, ki ga je mogoče hraniti v žepu zdravniške halje in ga uporabljati kot opomnik za preudarno predpisovanje antibiotikov. The poster contains a key message that is deemed relevant overall for the hospital or the healthcare setting, followed by a set of actions that the hospital prescriber can/should/must implement to ensure that antibiotics remain effective. 1.4777777777777779 Z upoštevanjem navodil glede rabe antibiotikov in sodelovanjem pri izobraževalnih vizitah se bo predpisovanje antibiotikov izboljšalo Using antibiotic guidance and attending educational rounds improve antibiotic prescribing. 1.4761904761904763 Remove this filter Audience: Zdravstveni delavci v bolnišnicah Remove this filter Type: materiālu rīkkopa 1.1902985074626866 Dopisi za nacionalne organe javnega zdravstva, ki se pošljejo farmacevtom in predpisovalcem zdravil v primarnem zdravstvenem varstvu za predstavitev kampanje evropski dan ozaveščanja o antibiotikih, s katero se spodbuja ustrezna uporaba antibiotikov in se bolniki seznanjajo o nevarnostih samozdravljenja z antibiotiki. Letters for national public health authorities to send to pharmacists and primary care prescribers to introduce European Antibiotic Awareness Day (EAAD), to promote appropriate use of antibiotics and inform patients about the risks of self-medication with antibiotics. 1.6333333333333333 Osnutki pisem farmacevtom in zdravnikom, ki predpisujejo zdravila v primarnem zdravstvenem varstvu Template letters to pharmacists and primary care prescribers 3.0 komplet informativnega gradiva Media type 0.2857142857142857 Razvrsti po: Remove this filter Type: materiālu rīkkopa 0.4697986577181208 Ključna sporočila za zdravnike, ki predpisujejo zdravila v bolnišnicah Documenting indication, drug choice, dose, route of administration and duration of treatment in the patient chart leads to better use of antibiotics. 1.5471698113207548 grafični prikaz informacij, informativno gradivo, komplet informativnega gradiva - infographic, information material, toolkit material - 0.963302752293578 V njej je pojasnjeno, kaj je odpornost proti antibiotikom, in poudarjen obseg težav, s katerimi se spopadamo zaradi odpornosti proti antibiotikom in uporabe antibiotikov pri ljudeh - v bolnišnicah in skupnosti. The infographic explains what antibiotic resistance is and highlights the extent of the problems that we are facing due to antibiotic resistance and antibiotic consumption in humans - in hospitals and in the community. 0.9645390070921985 Ta grafični prikaz pojasnjuje, kako se odpornost proti antibiotikom širi v živinoreji, skupnosti, zdravstvenih ustanovah in s potovanji. This infographic explains how antibiotic resistance spreads in animal farming, in the community, in healthcare facilities and through travel. 1.064516129032258 Zdravstveni delavci v bolnišnicah healthcare workers in hospitals 1.162162162162162 Ključna sporočila za bolnišnične farmacevte Key messages for hospital prescribers 0.5833333333333334 Uporabi Infographics 1.1917808219178083 Ključna sporočila za zdravstvene delavce v bolnišnicah in drugih zdravstvenih ustanovah Key messages for professionals in hospitals and other healthcare settings 1.38 informativno gradivo ključna sporočila komplet informativnega gradiva information material key messages toolkit material 1.0 Remove this filter Type: zgodbe bolnikov Remove this filter Type: patient stories 1.118279569892473 Paolo je hudo zbolel za hudo okužbo sečil, ki jo je povzročila na antibiotike odporna bakterija E. coli. Paolo fell ill with a serious urinary infection with an E.coli resistant to many antibiotics. 0.9425287356321839 Pridobite več informacij o odpornosti proti antibiotikom, o tem, kdaj je lahko raba antibiotikov koristna, ter zakaj in kako spodbujati preudarno rabo antibiotikov. This infographic highlights the threat that antibiotic resistance poses and the effectiveness of antibiotic stewardship programmes to address the issue from different angles. 1.3061224489795917 Remove this filter Audience: predpisovalci zdravil v bolnišnicah Remove this filter Audience: hospital prescribers 1.8918918918918919 Ključna sporočila za zdravnike, ki predpisujejo zdravila v bolnišnicah Key messages for hospital prescribers 0.7551020408163265 slika, komplet informativnega gradiva factsheet, information material, toolkit material 1.894736842105263 Predloga dopisa za predpisovalce zdravilv primarnem zdravstvenem varstvu Factsheet for primary care prescribers 1.2 Seznam Apply 1.0 Pregled podatkov o odpornost proti mikrobom v Evropi, objavljenih leta 2014 Overview of the data on antimicrobial resistance in Europe released in 2014 0.9426751592356688 Širjenje okužb, odpornih proti karbapenemom, ogroža zdravstveno varstvo in varnost bolnikov v Evropi, saj resno zmanjšuje možnost zdravljenja okužb. The spread of carbapenem-resistant infections is a threat to healthcare and patient safety in Europe as it seriously curtails the ability to cure infections. 1.0 Karbapenemi so glavna vrsta rezervnih antibiotikov za zdravljenje bakterijskih okužb. Carbapenems are a major last-line class of antibiotics to treat bacterial infections. 1.2244897959183674 Naraščajoča odpornost proti rezervnim antibiotikom leta 2013 Growing resistance to last-line antibiotics: 2013 1.4285714285714286 grafični prikaz informacij, informativno gradivo - infographic, information material - 1.5 splošna javnost Media type 1.0491803278688525 Družbeni mediji so lahko del nacionalnih kampanj za preudarno uporabo antibiotikov, namenjenih splošni javnosti ter predpisovalcem antibiotikov v primarnem zdravstvenem varstvu in bolnišnicah. Social media activities that could be undertaken as part of national prudent antibiotic use campaigns, targeting the general public, primary care prescribers and hospital prescribers. 0.8904109589041096 Komplet vsebuje predloge gradiv in ključna sporočila, ki se osredotočajo na samozdravljenje z antibiotiki, zamisli za ozaveščanje in predlagane pristope za posredovanje sporočil splošni javnosti. The toolkit contains template materials and key messages focusing on self-medication with antibiotics, ideas for awareness raising activities, and suggested tactics for getting the messages across to the general public. 1.3 Komplet informativnega gradiva za vključitev družabnih medijev v spodbujanje preudarne rabe antibiotikov Toolkit for engaging in social media activities promoting prudent antibiotic use 2.2857142857142856 slovenščina (sl) Country 0.9773755656108597 Komplet vsebuje predloge gradiv in ključna sporočila za zdravstvene delavce, zamisli za ozaveščanje ter predlagane pristope za posredovanje sporočil zdravstvenim delavcem v primarnem zdravstvenem varstvu in bolnikom. The toolkit contains template materials and key messages for health professionals, ideas for awareness raising activities, and suggested tactics for getting the messages across to both primary care providers and patients. 1.4285714285714286 komplet informativnega gradiva communication toolkit 1.446808510638298 Ta grafični prikaz pojasnjuje, kako se odpornost proti antibiotikom širi v živinoreji, skupnosti, zdravstvenih ustanovah in s potovanji. Antibiotics are not the solution for infections caused by viruses such as common colds or flu. 2.0 grafični prikaz informacij, informativno gradivo, komplet informativnega gradiva - Remove this filter Type: toolkit material 1.0416666666666667 Remove this filter Audience: organizatorji kampanj Remove this filter Audience: campaign organisers 0.6156716417910447 Evropski dan antibiotikov je evropska zdravstvena pobuda, ki je namenjena zagotavljanju platforme in podpore za nacionalne kampanje o preudarni uporabi antibiotikov. Letters for national public health authorities to send to pharmacists and primary care prescribers to introduce European Antibiotic Awareness Day (EAAD), to promote appropriate use of antibiotics and inform patients about the risks of self-medication with antibiotics. 1.0 Nabor orodij za zdravstvene delavce v bolnišnicah in drugih zdravstvenih ustanovah Communication toolkit for professionals in hospitals and other healthcare settings 1.072289156626506 Napačna uporaba antibiotikov v bolnišnicah je glavni vzrok odpornosti proti antibiotikom. Healthcare professionals play a fundamental role in tackling antibiotic resistance. 1.0731707317073171 Remove this filter Audience: splošna javnost Remove this filter Type: toolkit material 1.1685393258426966 Komplet informativnega gradiva za vključitev družabnih medijev v spodbujanje preudarne rabe antibiotikov Communication toolkit to promote prudent antibiotic use aimed at primary care prescribers 0.6153846153846154 IščiIšči Find out more 0.9354838709677419 Kdaj naj jemljem antibiotike? When should I take antibiotics? 1.1020408163265305 Antibiotiki izgubljajo svojo učinkovitost celo hitreje, kot je bilo mogoče predvideti pred petimi leti [11]. Antibiotics are losing their effectiveness at a pace that was unforeseen even five years ago [11]. 0.8017241379310345 Pravilno diagnozo in odločitev o tem, ali so antibiotiki potrebni, lahko sprejme le zdravnik. The correct diagnosis and the decision about whether antibiotics are necessary can only be made by a medical doctor. 0.8955223880597015 Antibiotiki ne preprečujejo širjenja virusov na druge osebe. Antibiotics do not prevent viruses from spreading to other persons. 0.8833333333333333 Antibiotiki učinkujejo le proti bakterijskim okužbam. Antibiotics are effective only against bacterial infections. 0.7099236641221374 Če je zdravnik potrdil, da so antibiotiki nujni, je zelo pomembno, da jih jemljete odgovorno. When the doctor has confirmed that antibiotics are necessary, it is very important to take the antibiotics in a responsible manner. 0.9761904761904762 Če ste dobili več odmerkov, kot vam jih je bilo predpisanih, se o odstranjevanju ostankov zdravil posvetujte s farmacevtom. If you have received more doses than you were prescribed, ask your pharmacist about how to dispose of the remaining medicines. 0.9710144927536232 Pomnite: Za ohranjanje učinkovitosti antibiotikov smo odgovorni vsi Remember: Keeping antibiotics effective is everybody's responsibility 1.0 To je zdravstveno tveganje ne samo za osebo, ki je antibiotike neustrezno jemala, temveč tudi za vse druge osebe, ki jih lahko v prihodnje kolonizira odporna bakterija. This is a health hazard not just for the person having taken the antibiotics inappropriately but also for anyone else who might catch the resistant bacteria afterwards. 1.0677966101694916 Pomnite: Antibiotiki v primeru prehlada ali gripe ne učinkujejo Remember: Antibiotics won't work in the case of cold or flu 1.0841121495327102 Napačna ali nepravilna uporaba antibiotikov lahko povzroči, da postanejo bakterije odporne na prihodnja zdravljenja. Wrong or incorrect use of antibiotics may cause the bacteria to become resistant against future treatments. 1.4929577464788732 To pomeni, da antibiotiki v prihodnje, ko jih boste potrebovali, pri vas morda ne bodo več učinkovali [6]. So when you need antibiotics in the future they may no longer work [6]. 1.098159509202454 Antibiotike jemljite le takrat, kadar vam jih predpiše zdravnik, in upoštevajte navodila zdravnika o načinu uporabe antibiotikov, tako da bodo pri vas učinkovali tudi v prihodnje. Take antibiotics only when prescribed by a doctor and follow the doctor's advice on how to take the antibiotics so that they can stay effective also in the future. 0.7916666666666666 Ne hranite ostankov antibiotikov [10]. Do not keep leftover antibiotic treatments [10]. 1.056338028169014 Antibiotiki pogosto povzročajo neželene učinke, kot je driska [1, 2, 7, 8]. Antibiotics often give you side effects such as diarrhoea [1, 2, 7, 8]. 0.9428571428571428 Antibiotikov ne jemljite v napačen namen ali nepravilno [1, 2, 9]. Do not use antibiotics for the wrong reasons or incorrectly [1, 2, 9]. 2.225806451612903 informativno gradivo ključna sporočila komplet informativnega gradiva Twitter Facebook Linked In Mail 0.9787234042553191 Antibiotiki ne ozdravijo okužb, ki jih povzročajo virusi, kot je običajen prehlad ali gripa. Antibiotics are not the solution for infections caused by viruses such as common colds or flu. 1.0271739130434783 Uporaba antibiotikov povzroči, da postanejo bakterije odporne na zdravljenje z antibiotiki [3, 4, 5], zato je pomembno, da antibiotikov ne jemljete v napačen namen ali nepravilno [1, 2, 9]. Antibiotic use causes bacteria to become resistant to antibiotic treatments [3, 4, 5], therefore it is important not to take antibiotics for the wrong reasons or incorrectly [1, 2, 9]. 0.821656050955414 Antibiotiki učinkujejo le proti bakterijskim okužbam - ne morejo ozdraviti virusnih okužb, kot je običajen prehlad ali gripa [1]. Antibiotics are effective only against bacterial infections - they cannot help you recover from infections caused by viruses such as common colds or flu [1]. 1.0612244897959184 Zloraba antibiotikov povzroči le, da postanejo bakterije odporne na zdravljenje z antibiotiki [3, 4, 5]. Misuse of antibiotics only causes bacteria to become resistant to antibiotic treatments [3, 4, 5]. 0.8492462311557789 Če bomo antibiotike še naprej tako pogosto uživali kot zdaj, se lahko v Evropi vrnemo v obdobje pred pojavom antibiotikov, tako da bodo običajne bakterijske okužbe, npr. If we continue to consume antibiotics at the current rate, Europe may face a return to the pre-antibiotic era, where a common bacterial infection such as pneumonia could be a death sentence [12, 13]. 1.1326530612244898 Razlog za to je, da postanejo zaradi uporabe antibiotikov bakterije odporne na zdravljenje z antibiotiki [3-5]. This is because antibiotic use causes bacteria to become resistant to antibiotic treatments [3-5]. 1.0140845070422535 Glede časa in načina odgovornega jemanja antibiotikov vedno upoštevajte navodila zdravnika, tako da bodo ohranili učinkovitost tudi v prihodnje. Always follow your doctor's advice on when and how to use antibiotics in a responsible way so that they can stay effective also in the future. 0.5408163265306123 proti prehladu ali gripi, vam ne bo koristilo [1, 2]. Taking antibiotics for wrong reasons, such as against colds or flu, has no benefit for you [1, 2]. 1.0169491525423728 Pred jemanjem antibiotikov se vedno posvetujte z zdravnikom. Always seek your doctor's advice before taking antibiotics. 1.0232558139534884 Remove this filter Audience: splošna javnost Remove this filter Audience: general public 1.14 Več informacij na naslovu: www.antibiotic.ecdc.europa.eu. More information at: www.antibiotic.ecdc.europa.eu 1.063063063063063 Bakterije, odporne proti antibiotikom, pomenijo nevarnost za vse nas, ker povzročajo okužbe, ki jih je težko zdraviti. Antibiotic-resistant bacteria are a danger to us all because they cause infections that are difficult to treat. 1.0096153846153846 Šestina Evropejcev se ne zaveda, da napačna uporaba antibiotikov zmanjša njihovo učinkovitost (podnapisi) 1/6 of Europeans are not aware that the misuse of antibiotics makes them less effective (with subtitles) 1.488888888888889 informativno gradivo, komplet informativnega gradiva, videoposnetek information material, toolkit material, video 1.1643835616438356 Čezmerna uporaba antibiotikov in njihova zloraba povzročata odpornost proti mikrobom. The over-use and misuse of antibiotics leads to antimicrobial resistance. 1.2592592592592593 Prehlad in gripo preženemo z ustrezno skrbjo zase, ne z antibiotiki. If you have a cold or flu, take care, not antibiotics. 0.9705882352941176 Več skrbi zase, manj antibiotikov Take care, not antibiotics (short) 1.1521739130434783 Remove this filter Type: nabor komunikacijskih orodij Remove this filter Type: communication toolkit 1.5121951219512195 Remove this filter Audience: Zdravstveni delavci v bolnišnicah Remove this filter Type: toolkit material 0.7471910112359551 Z upoštevanjem navodil glede rabe antibiotikov in sodelovanjem pri izobraževalnih vizitah se bo predpisovanje antibiotikov izboljšalo A patient leaflet for primary care prescribers to hand out to patients: it explains to patients what antibiotic resistance is and why appropriate use of antibiotics is important. 1.368421052631579 zdravstveni delavci v primarnem zdravstvenem varstvu Factsheet for primary care prescribers 0.36231884057971014 EVROPSKI DAN ANTIBIOTIKOV First-of-its kind survey on knowledge and attitudes about antibiotics 0.8524590163934426 Vsi smo odgovorni za preudarno uporabo antibiotikov. It is everyone's responsibility to use antibiotics prudently. 1.0227272727272727 Bolniki, zdravniki, medicinske sestre: vsi so odgovorni za preudarno uporabo antibiotikov. Patients, doctors, nurses: it is everyone's responsibility to use antibiotics prudently. 0.8787878787878788 Brez antibiotikov ne bomo mogli zdraviti preprostih okužb. Without #antibiotics, we won't be able to treat simple infections. 1.0714285714285714 Antibiotiki so učinkoviti samo proti bakterijskim okužbam in ne morejo pomagati proti prehladu ali gripi. #Antibiotics are only effective against bacterial infections and cannot help against cold or #flu. 1.9166666666666667 Pridružite se nam in poskrbite, da #OhranimoUčinkovitostAntibiotikov! Join us and #KeepAntibioticsWorking! 1.4140625 S preudarno uporabo antibiotiki ter preprečevanjem in obvladovanjem okužb se lahko borimo proti odpornosti proti antibiotikom in pripomoremo k ohranjanju učinkovitosti antibiotikov. Prudent use of #antibiotics and infection prevention & control can fight #AntibioticResistance and help #KeepAntibioticsWorking. 1.2884615384615385 Povejte, kako si prizadevate, da #OhranimoUčinkovitostAntibiotikov! Share what you are doing to #KeepAntibioticsWorking! 1.2916666666666667 informativno gradivo, plakat, komplet informativnega gradiva - information material, poster, toolkit material - 0.8852459016393442 Ali je to učinkovita zaščita proti prehladu ali gripi? Poster: Is this an effective protection against colds or flu? 0.9166666666666666 Tudi antibiotiki niso. Neither are antibiotics. 0.3629032258064516 proti prehladu ali gripi, vam ne bo koristilo Taking antibiotics against a cold or the flu has no benefit for you: antibiotics simply do not work against viral infections 1.0168539325842696 S povečevanjem odpornosti proti antibiotikom je ogrožena njihova sedanja in prihodnja učinkovitost: dobra komunikacija z bolniki je ključna za reševanje te vedno širše problematike. A patient leaflet for primary care prescribers to hand out to patients: it explains to patients what antibiotic resistance is and why appropriate use of antibiotics is important. 1.5609756097560976 Remove this filter Audience: predpisovalci zdravil v bolnišnicah Remove this filter Type: toolkit material 1.2 Razvrsti po: Media type 0.7971014492753623 Breme okužb z bakterijami, odpornimi proti antibiotikom First-of-its kind survey on knowledge and attitudes about antibiotics 0.4852941176470588 Zdravstveni delavci v bolnišnicah Letters for professionals in hospitals and other healthcare settings 1.3043478260869565 informativno gradivo, plakat, komplet informativnega gradiva information material, poster, toolkit material 1.4857142857142858 informativno gradivo, komplet informativnega gradiva infographic, information material - 1.261744966442953 V predstavitvi, ki jo je mogoče uporabiti za usposabljanje bolnišničnega osebja, so podrobno opisana ključna vprašanja glede odpornosti proti antibiotikom in načini za njihovo boljšo rabo. Documenting indication, drug choice, dose, route of administration and duration of treatment in the patient chart leads to better use of antibiotics. 0.8181818181818182 Kaj morate vedeti? Things you should know 1.5277777777777777 Na katerih področjih lahko delujete oziroma sodelujete? Things you can do, or collaborate on 1.162162162162162 Ključna sporočila za bolnišnične farmacevte Key messages for hospital pharmacists 1.1388888888888888 Vaše naloge v zvezi z izboljšanjem rabe antibiotikov vključujejo [42,56,76,94,95]: Your tasks related to improving antibiotic use include [42,56,76,94,95]: 1.1506849315068493 S tem se skrajša trajanje zdravljenja in zmanjšajo celotni stroški zdravljenja [77]. These reduce treatment durations and lower the overall cost of care [77]. 0.8695652173913043 Podpirajte razvoj in izvajanje programa za nadzor nad rabo antibiotikov v vaši organizaciji [69,94]. Support the development and implementation of an antibiotic stewardship programme within your organisation [69,94]. 1.065217391304348 Zbirajte in delite podatke o rabi in stroških antibiotikov na ravni oddelka in bolnišnice [56,76]. Collect and share data on antibiotic use and costs at ward level and hospital level [56,76]. 0.9774774774774775 Če ugotovite, da je zdravstveni delavec v bolnišnici ali zdravstveni ustanovi kršil smernice oziroma protokole, ga vprašajte, zakaj je tako ravnal, in mu pomagajte razumeti, kaj dela narobe [69] [strokovno usklajeno]. If you see staff members at the hospital or healthcare setting who breach guidelines or protocols, ask them why they are doing so and provide them with tools to understand what they are doing wrong [69] [expert consensus]. 1.0918918918918918 Farmacevti imajo lahko več vlog na urgentnem oddelku, vključno s posredovanjem povratnih informacij v realnem času, posvetovanjem v zvezi s prakso predpisovanja in ugotavljanjem interakcij med zdravili. Pharmacists can have multiple roles in the emergency department, including giving real-time feedback and consultation regarding prescribing practices, and identifying drug interactions. 0.9753086419753086 a) sodelovanje v skupini za nadzor nad rabo antibiotikov kot njen ključni član; a) Participating in the antibiotic stewardship team, as a key member of the team; 1.2335329341317365 Redno usposabljajte zdravnike, ki predpisujejo zdravila v bolnišnici, o preudarni rabi antibiotikov in sodelujte na srečanjih o izvajanju z dokazi podprtih bolnišničnih smernic o antibiotikih [31,53,94,95]. Train hospital prescribers regularly on prudent antibiotic use and participate in meetings on implementing evidence-based hospital antibiotic guidelines [31,53,94,95]. 0.9578947368421052 f) analiziranje podatkov o rabi antibiotikov in stroških za nadzor ter primerjalne analize; f) Analysing data on antibiotic use and costs for the purpose of surveillance and benchmarking; 1.0736196319018405 Posebni obrazci za naročanje antibiotikov omejujejo trajanje kirurške antibiotične profilakse ter zmanjšujejo incidenco okužb kirurških ran, rabo antibiotikov in stroške [56]. Special order forms limit the duration of perioperative antibiotic prophylaxis and reduce the incidence of surgical site infections, antibiotic use and costs [56]. 1.2975206611570247 d) posvetovanje z zdravniki, ki predpisujejo zdravila v bolnišnici, in posredovanje povratnih informacij, da se zagotovi kakovost predpisovanja antibiotikov; d) Consulting with hospital prescribers and providing them with feedback to ensure the quality of antibiotic prescribing; 0.8115942028985508 b) sodelovanje z infektologom in kliničnim mikrobiologom pri izvajanju programa za nadzor nad rabo antibiotikov; b) Collaborating with the infectious disease specialist and the clinical microbiologist to implement the antibiotic stewardship programme; 1.243421052631579 Skupaj z zdravniki, ki predpisujejo zdravila, bolnikom, ki morajo zdravljenje z antibiotiki nadaljevati še po odpustu iz bolnišnice, posredujte informacije o jemanju antibiotikov doma [31]. Together with prescribers, provide patients who have to continue antibiotic therapy after discharge with information on use of antibiotics at home [31]. 1.1585365853658536 e) izvajanje ukrepov glede omejitev kataloga zdravil, kot so zahteve za pridobitev predhodnega dovoljenja in naknadna odobritev rabe antibiotika ter ocenjevanje skladnosti s temi omejitvami; e) Implementing interventions on formulary restrictions, such as pre-approval and post-authorisation requirements, and assessing compliance with these restrictions; 1.2248062015503876 Zdravnikom, ki predpisujejo zdravila, zagotovite povratne informacije ter nasvete o izbiri, odmerku, optimizaciji trajanja in načinu dajanja zdravila [31,94]. Provide feedback and advice to prescribers on antibiotic choice, dose, duration optimisation and route of administration [31,94]. 1.009009009009009 g) podpiranje z dokazi podprtih bolnišničnih smernic o antibiotikih pri pogostih okužbah in kirurški profilaksi; g) Supporting evidence-based hospital antibiotic guidelines for common infections and for surgical prophylaxis; 1.0823529411764705 Klinike spodbujajte, naj pravočasno preidejo s parenteralnega na peroralno zdravljenje [56]. Encourage clinicians to perform appropriately timed parenteral-to-oral switches [56]. 1.02 Z upoštevanjem omejitev kataloga zdravil ter zahtev za pridobitev predhodnega dovoljenja in naknadno odobritev določenih antibiotikov se zmanjša njihova uporaba na oddelkih za intenzivno zdravljenje [43]. Compliance with formulary restrictions as well as pre-approval and post-authorisation requirements for specific antibiotics decreases the use of these antibiotics in intensive care unit settings [43]. 0.7361963190184049 preverjanje interakcij med zdravili, optimizacija odmerka in načinov dajanja zdravila, preprečevanje neželenih učinkov); c) Improving the quality of antibiotic prescribing (e.g. checking for drug interactions, optimising dosage and route of administration, preventing adverse events); 1.2181818181818183 Na podlagi smernic, podprtih z dokazi, preverjajte, ali se pri predpisovanju antibiotikov upoštevajo protokoli za zdravljenje z njimi. Check that antibiotic prescriptions follow antibiotic treatment protocols, based on evidence-based guidelines. 0.5423728813559322 krajše trajanje parenteralnega zdravljenja brez negativnih posledic za klinične rezultate) [56]. Pharmacist-led parenteral-to-oral switches improve clinical outcomes (e.g. shortening the duration of parenteral therapy without negatively impacting on clinical outcomes) [56]. 0.63 h) vodenje bolnišničnih katalogov protimikrobnih sredstev (npr. h) Managing your hospital's antimicrobial formulary (i.e., list of drugs available for prescribers). 2.2 Več o dnevu About 1.0547945205479452 Preudarna raba antibiotikov lahko pomaga ustaviti razvoj odpornih bakterij ter pripomore, da antibiotiki ostanejo učinkoviti tudi za naslednje generacije. Prudent use of antibiotics can help stop resistant bacteria from developing and help keep antibiotics effective for the use of future generations. 0.9541666666666667 Evropski dan ozaveščanja o antibiotikih je evropska zdravstvena pobuda, organizirana vsako leto 18. novembra za ozaveščanje o nevarnostih, ki jih za javno zdravje predstavlja odpornost na antibiotike ter o njihovi preudarni rabi. The European Antibiotic Awareness Day is an annual European public health initiative that takes place on 18 November to raise awareness about the threat to public health of antibiotic resistance and the importance of prudent antibiotic use. 0.9894736842105263 Najnovejši podatki potrjujejo, da število bolnikov, okuženih z odpornimi bakterijami, v Evropski uniji narašča, ter da je odpornost bakterij na antibiotike velika grožnja za javno zdravje. The latest data confirms that across the European Union the number of patients infected by resistant bacteria is increasing and that antibiotic resistance is a major threat to public health. 1.0 Mednje sodijo: These include: 1.0588235294117647 Kaj lahko storite? Thinks you can do 1.125 Druge naloge vključujejo [31,42,56,82,85-87]: Other tasks include [31,42,56,82,85-87]: 0.9387755102040817 c) aseptične tehnike in klinične intervencije; c) aseptic techniques and clinical interventions, 1.3076923076923077 a) izobraževanje in usposabljanje; a) education and training, 1.024390243902439 Ta lahko vključujejo smernice, protokole in kontrolne sezname [strokovno usklajeno]. This guidance can include guidelines, protocols and checklists [expert consensus]. 1.2 i) sodelovanje z javnimi zdravstvenimi organizacijami; i) liaising with public health organisations, 1.2470588235294118 Program je zajemal ukrepe za nadzor nad rabo antibiotikov, ki so bili usmerjeni na rabo karbapenemov [62]. The programme included antibiotic stewardship measures targeting carbapenem use [62]. 0.96875 Če ugotovite, da je zdravstveni delavec v bolnišnici ali zdravstveni ustanovi kršil smernice oziroma protokole, ga vprašajte, zakaj je tako ravnal, in mu pomagajte razumeti, kaj dela narobe [69] [strokovno usklajeno]. If you see staff members at the hospital or healthcare setting who breaches guidelines or protocols, ask them why they are doing so and provide them with tools to understand what they are doing wrong [69] [expert consensus]. 1.1009174311926606 k) zagotavljanje, da vsi zaposleni (od vodstva do zaposlenih na oddelkih), razumejo svojo vlogo pri preprečevanju okužb. k) ensuring, from the board level to the ward, that all staff understand their role in preventing infections. 0.8347826086956521 Portal ECDC (povezava) vsebuje spletne vire za preprečevanje in obvladovanje bolnišničnih okužb. The ECDC directory (link) contains online resources for prevention and control of healthcare-associated infections. 1.2375 c) izmenjavo informacij o lokalnih mikrobioloških vzorcih in vzorcih odpornosti proti antibiotikom; c) Sharing information on local microbiology and antibiotic resistance patterns; 1.0606060606060606 j) vključevanje preprečevanja in obvladovanja okužb v vse politike ter j) embedding infection prevention and control in all policies, and 1.0895522388059702 h) cepljenje zdravstvenih delavcev v okviru varnosti in zdravja pri delu; h) vaccination of healthcare workers alongside occupational health, 1.1287128712871286 Ključna sporočila za strokovnjake za preprečevanje in obvladovanje bolnišničnih okužb ter bolnišnične epidemiologe Key messages for hospital infection prevention and control professionals and hospital epidemiologists 0.7724550898203593 • točkovnih raziskav o razširjenosti okužb, ki nudijo pregled nad številom bolnikov z bolnišničnimi okužbami v danem trenutku, in • Point prevalence surveys, which give a snapshot picture of the number of patients with healthcare-associated infection in hospital at a particular point in time, and 1.160621761658031 g) izobraževanje vseh zadevnih zdravstvenih delavcev o ukrepih za preprečevanje in obvladovanje okužb za zmanjšanje prenosa tako bakterij, ki so odporne proti antibiotikom, kot tudi bakterij, ki so za antibiotike občutljive. g) Educating all relevant healthcare professionals on infection prevention and control interventions to reduce the transmission of both antibiotic-resistant and antibiotic-susceptible bacteria. 1.0 programi za preprečevanje in obvladovanje okužb; programmes for infection prevention and control; 1.1277777777777778 Uporabite lokalne podatke o bolnišničnih okužbah, določite lokalne cilje in določite področja, na katerih je potrebna dodatna podpora za preprečevanje in obvladovanje okužb [82,85] [strokovno usklajeno]. Use local data on healthcare-associated infections, set local targets and find areas where additional infection prevention and control support is needed [82,85] [expert consensus]. 1.1385542168674698 Italija - z izvajanjem štiriletnega programa za obvladovanje okužb v učni bolnišnici se je zmanjšala incidenca okužb in kolonizacije, ki jo povzročajo bakterije, odporne proti karbapenemom. Italy - A four-year infection control programme decreased the incidence of infections and colonisation caused by carbapenem-resistant bacteria in a teaching hospital. 1.054054054054054 d) spremljanje skladnosti s smernicami za preprečevanje in obvladovanje okužb; d) Monitoring compliance with infection prevention and control guidelines; 1.0897435897435896 f) zagotavljanje skladnosti programov za nadzor nad rabo antibiotikov s politikami in f) Ensuring antibiotic stewardship programmes are integrated with policies and 1.0405405405405406 Grčija - z izvajanjem triletnega vsestranskega programa za obvladovanje širjenja okužb z bakterijami, odpornimi proti karbapenemom, se je na hematološkem oddelku terciarne bolnišnice zmanjšalo število okužb s temi bakterijami [88]. Greece - A three-year multifaceted infection control programme to control the spread of carbapenem-resistant bacteria in a haematology unit of a tertiary care hospital led to fewer infections caused by these bacteria [88]. 1.0218579234972678 b) zagotavljanje, da so smernice, protokoli in kontrolni seznami za preprečevanje in obvladovanje okužb na voljo za preprečevanje tako bolnišničnih okužb kot tudi prenosa mikroorganizmov; b) Ensuring infection prevention and control guidelines, protocols and checklists are available for preventing both healthcare-associated infections and transmission of microorganisms 1.1214285714285714 Spremljajte učinkovitost ciljno usmerjenih preventivnih ukrepov pri zmanjševanju prenosa bakterij, odpornih proti antibiotikom [82,85] [strokovno usklajeno]. Monitor how effective targeted preventive measures are at reducing transmission of antibiotic-resistant bacteria [82,85] [expert consensus]. 0.9240506329113924 Vaša naloga je zagotoviti izvajanje bistvenih delov programa za preprečevanje in obvladovanje bolnišničnih okužb [82,84,85] [strokovno usklajeno]. Your task is to ensure that the fundamental elements of the hospital infection prevention and control programme are carried out [82,84,85] [expert consensus]. 1.0151515151515151 Redno usposabljajte zdravstvene delavce o izvajanju učinkovitih strategij preprečevanja in obvladovanja [82,85] [strokovno usklajeno]. Train healthcare professionals regularly on how to implement effective prevention and control strategies [82,85] [expert consensus]. 0.47183098591549294 na oddelkih za intenzivno zdravljenje ali za določene vrste okužb). • Long-term surveillance of the incidence of healthcare-associated infections (e.g. in intensive care units, or for specific infection types). 0.7368421052631579 Uskladite nadzor nad bolnišničnimi okužbami z uporabo [82,85] [strokovno usklajeno]: Coordinate hospital surveillance of healthcare-associated infection through using both [82,85] [expert consensus]: 1.0 e) pregledovanje in sporočanje podatkov o nadzoru nad bolnišničnimi okužbami; e) Auditing and reporting healthcare-associated infections surveillance data; 1.5 a) Usklajevanje oziroma koordinacija bolnišničnega epidemiološkega spremljanja nadzorovanja bolnišnic ter programov za preprečevanje in obvladovanje bolnišničnih okužb; a) Coordinating hospital surveillance and prevention and control programmes of healthcare-associated infections; 0.6428571428571429 Organizirajte in spodbujajte izobraževalne dogodke, tečaje in srečanja skupaj z vodstvom bolnišnice, da bi okrepili preprečevanje in obvladovanje okužb med vsemi zdravstvenimi delavci (npr. Organise and promote educational events, courses and meetings together with hospital administrators to strengthen infection prevention and control activities among all healthcare professionals (e.g. hand hygiene, contact precautions, active screening cultures, and environmental cleaning) [89]. 0.8176470588235294 Poskrbite, da bodo pravočasno in zagotovo na voljo navodila za preprečevanje in obvladovanje bolnišničnih okužb in prenosa mikroorganizmov. Make guidance for infection prevention and control measures to reduce healthcare-associated infections and transmission of microorganisms readily and reliably accessible. 0.8863636363636364 ECDC bo z veseljem pregledal spremembe. ECDC is happy to double check modifications. 0.9895833333333334 Zelo bomo hvaležni, če ne boste dodajali grafičnih elementov, kar ne velja za dodatne logotipe. We would appreciate that graphic elements are not added, with the exception of additional logos. 0.7541899441340782 Če spremenite datoteko in namestite pisavo, ECDC zahteva, da po spreminjanju pisavo odstranite, saj ECDC zanjo ne sme odobriti licence. If you modify the file and install the font, ECDC requires that you de-install the font after finishing the modification since ECDC is not allowed to grant a license for the font. 1.1595744680851063 Prosimo vas, da ne spreminjate barv, presledkov, razporeditve ali velikosti pisave (če to ni nujno potrebno). Please do not change colours, spacing, arrangement or font size (if not absolutely necessary). 0.8690476190476191 Če želite spremeniti grafični prikaz informacij, boste morali namestiti pisavo (Meta Pro), preden lahko odprete datoteko Illustrator ali InDesign. In case you would like to modify the infographic, please note that you will need to install the Font package (Meta Pro) before opening the Illustrator or InDesign file. 0.7714285714285715 Uporaba antimikrobikov v evropskih bolnišnicah in ustanovah za dolgotrajno oskrbo Antimicrobial use in European hospitals and long-term care facilities - Design files - EN - [ZIP-4.26 MB] 0.8939393939393939 Ne odprite datoteke .ai, če niste prej namestili teh pisav. Do not open the .ai file without having the fonts installed first. 1.5227272727272727 informativno gradivo, komplet informativnega gradiva, videoposnetek Remove this filter Type: teabepakme materjal 0.38461538461538464 EVROPSKI DAN ANTIBIOTIKOV European Antibiotics Awareness Day, a European Health Initiative. 0.9565217391304348 Informacije za bolnike Information to patients 1.0625 Postanite partner Become a partner 1.2941176470588236 Pridružite se kampanji Join the campaign 1.135135135135135 Natisnite in posredujte informacijsko gradivo, ki je na voljo na tem spletnem mestu. Print and disseminate the information materials available on this website. 1.4190476190476191 Sledite nam na Twitterju, tvitnite #EAAD ali se udeležite naših pogovorov na Twitterju o evropskem dnevu antibiotikov: http://www.twitter.com/EAAD_EU Follow us on Twitter, use #EAAD or take part in our twitter chats on EAAD: http://www.twitter.com/EAAD_EU 1.0837696335078535 Pomagajte pri oglaševanju evropskega dneva ozaveščanja o antibiotikih v glasilih, na spletnih mestih, v medijih in internetu, z vstavljanjem povezave na vašem spletnem mestu, s podpisom v e-poštni ali blogu. Help advertise the European Antibiotic Awareness Day in newsletters, websites, in the media and on the Internet, by inserting a link on your website, in your e-mail signature or in your blog. 0.9940828402366864 Če ste zdravnik, so vam na voljo številna gradiva , v katerih je bolnikom razloženo, kaj je odpornost na antibiotike in zakaj je ustrezna uporaba antibiotikov pomembna. If you are a prescriber, you can see various materials for informing patients about antibiotic resistance and explaining why appropriate use of antibiotics is important. 0.8717948717948718 Če lahko sodelujete pri evropskem dnevu antibiotikov ali ga podprete, bomo z veseljem sodelovali z vami ter vam posredovali več informacij o naših dejavnostih in gradivu. If you can take part in or support European Antibiotic Awareness Day campaign, we will be delighted to cooperate with you and to provide you with more information on our activities and materials. 0.9726027397260274 Če organizirate informacijsko kampanjo za ozaveščanje o preudarni uporabi antibiotikov, lahko uporabite naše komplete in gradivo za kampanjo . If you are organising a communication campaign to raise awareness on prudent use of antibiotics, you can use our toolkits and campaign materials . 1.202970297029703 Evropski center za preprečevanje in obvladovanje bolezni se veseli sodelovanja z zainteresiranimi stranmi in organizacijami, ki podpirajo ali vodijo kampanje za ozaveščanje o preudarni uporabi antibiotikov, povezani z zdravjem ljudi in živali. ECDC is looking forward to collaborating with stakeholders at pan-European level and welcomes dialogues with organisations throughout the world running awareness campaigns on prudent use of antibiotics. 1.2666666666666666 Širjenje informacij Spread the word 0.5284552845528455 Prosimo, da stopite v stik z nami, če želite postati naš partner: Please contact us if you want to become a partner or if you need more information on the European Antibiotic Awareness Day: 1.063063063063063 Seznanite prijatelje, družinske člane in sodelavce o evropskem dnevu ozaveščanja o antibiotikih ter o njegovem pomenu. Talk about the European Antibiotic Awareness Day and its significance with your friends, family and colleagues. 1.0588235294117647 Kaj lahko storite? Things you can do 0.8088235294117647 Ali ima bolnik okužbo, ki se bo odzvala na antibiotike? Does the patient have an infection that will respond to antibiotics? 1.75 Ključna sporočila za zdravnike, ki predpisujejo zdravila Key messages for all prescribers 0.987603305785124 Redno sodelujte na usposabljanjih in srečanjih, ki v bolnišnicah podpirajo izvajanje a) preudarne rabe antibiotikov, b) lokalnih, z dokazi podprtih smernic o rabi antibiotikov, ter c) ukrepov za preprečevanje in obvladovanje okužb [52,53]. Regularly participate in training courses and in meetings that support the implementation in the hospital of: a) prudent antibiotic use, b) evidence-based, local antibiotic guidelines, and c) infection prevention and control measures [52,53]. 1.0729166666666667 • za smernice in nasvet prosite starejšega sodelavca ali člana skupine za nadzor nad rabo antibiotikov. Seek guidance and advice from a senior colleague or a member of the antibiotic stewardship team. 0.9621212121212122 Seznanite se z odpornostjo proti antibiotikom na vašem oddelku, v vaši bolnišnici in vaši skupnosti [31] [strokovno usklajeno]. Remain aware of local antibiotic resistance patterns in your department, your hospital and in the community [31] [expert consensus]. 1.205128205128205 Izobražujte se in upoštevajte vsa priporočila v zvezi z rabo antibiotikov in preprečevanjem ter nadzorom nad okužbami, ki so pomembna za vaše področje specializacije [strokovno usklajeno]. Learn and apply all antibiotic use and infection prevention and control recommendations that are relevant to your area of specialisation [expert consensus]. 1.163265306122449 Izogibajte se nepotrebni antibiotični profilaksi [31,73]. Avoid unnecessary antibiotic prophylaxis [31,73]. 0.8857142857142857 Pri bolnikih s hudimi okužbami čim prej začnite učinkovito zdravljenje z antibiotiki [31,74]. For patients with severe infections, initiate effective antibiotic treatment as soon as possible [31,74]. 1.0085470085470085 Zdravljenje z antibiotiki začnite samo, če obstajajo dokazi o bakterijski okužbi, in ne zdravite kolonizacije [31,72]. Only start antibiotic treatment if there is evidence of a bacterial infection, and do not treat colonisation [31,72]. 1.0927152317880795 Pri ponovni presoji o zdravljenju z antibiotiki po 48-72 urah (oziroma takoj, ko so znani mikrobiološki rezultati) odgovorite na naslednja ključna vprašanja [42,70]: Answer the following key questions when reassessing antibiotic therapy after 48-72 hours (or as soon as microbiological results are available) [42,70]: 1.0718954248366013 V bolnikovi kartoteki dokumentirajte indikacijo za zdravljenje z antibiotiki, vrsto zdravila, odmerek, način dajanja zdravila in trajanje zdravljenja [31,42,70,71]. Document the indication of antibiotic treatment, drug choice, dose, route of administration and duration of treatment in the patient chart [31,42,70,71]. 1.1484375 Poskrbite, da se pred začetkom zdravljenja z antibiotiki pravilno odvzamejo ustrezne kužnine in pošljejo v mikrobiološki laboratorij [31,42,70,71]. Ensure that cultures are appropriately taken and send to the microbiology laboratory, before starting antibiotics [31,42,70,71]. 3.5 EVROPSKA POBUDA NA PODROCJU ZDRAVJA Media type 1.04 Mednje spadajo [54,79-81]: These include [54,79-81]: 1.1666666666666667 c) izvajanje ciljno usmerjenih izobraževalnih dejavnosti in usposabljanj, ki: c) Implementing targeted educational activities and training that: 1.2448979591836735 Kaj lahko storite v vaši bolnišnici ali zdravstveni ustanovi? Things you can do in your hospital or institution 1.1388888888888888 Vaše naloge v zvezi z izboljšanjem rabe antibiotikov vključujejo [31,42,56,71,75]: Your tasks related to improving antibiotic use include [31,42,56,71,75]: 0.8817204301075269 Če v vaši bolnišnici nimate teh smernic, poskrbite za njihovo pripravo [31,54,56]. If these guidelines do not exist in your hospital, then support their development [31,54,56]. 0.9545454545454546 i. optimizirajo diagnostično in terapevtsko obravnavo bolnikov; i. optimise the diagnostic and therapeutic management of patients; 1.5454545454545454 • za 33 odstotkov zmanjšali stroški za antibiotike. Reducing antibiotic costs by 33%. 1.3162393162393162 Številni zdravniki, ki predpisujejo zdravila, in drugi zdravstveni delavci menijo, da je usposabljanje na področju preudarne rabe antibiotikov nezadostno. Many prescribers and other healthcare professionals believe their training in prudent antibiotic use is insufficient. 1.2209302325581395 Določene strukturne strategije lahko izboljšajo način predpisovanja antibiotikov in rezultate za bolnike. Certain structural strategies can improve antibiotic prescribing and patient outcomes. 1.0234375 e) določitev kazalnikov kakovosti in količinskih meril za merjenje napredka in rezultatov programa za nadzor nad rabo antibiotikov; e) Setting quality indicators and quantity metrics to measure the progress and outcomes of the antibiotic stewardship programme; 0.8733333333333333 Ta skupina bi morala vključevati infektologe, klinične mikrobiologe in farmacevte ter prejemati namenska finančna sredstva in vire; This team should include infectious disease specialists, clinical microbiologists and pharmacists, and should receive dedicated funding and resources; 1.1794871794871795 • za 20 odstotkov zmanjšala raba antibiotikov; Reducing antibiotic consumption by 20%, 0.8373205741626795 Izboljševanje rabe antibiotikov na urgentnem oddelku lahko vodi do boljše rabe antibiotikov v celotni ustanovi, saj je urgenca običajna točka vstopa v bolnišnično okolje [77]. Improving antibiotic use in the emergency department can lead to better antibiotic use across the entire organisation, because the emergency department is a common point of entry to the inpatient setting [77]. 0.9705882352941176 Z izvajanjem programov za nadzor nad rabo antibiotikov se je [46]: Implementing antibiotic stewardship programmes has resulted in [46]: 1.09 • omejevalni ukrepi vključujejo predhodno dovoljenje in naknadno odobritev za uporabo določenih antibiotikov; Restrictive measures include pre-approval and post-authorization decisions for specific antibiotics; 1.0140845070422535 Kliniki so odgovorni za predpisovanje zdravil in morajo biti v celoti vključeni v skupno odločanje skupine za nadzor nad rabo antibiotikov [42]. Clinicians are responsible for prescribing and they must be fully engaged in shared decision-making with the antibiotic stewardship team [42]. 1.0427350427350428 • računalniško podprte odločitve, ki združujejo klinične indikacije, mikrobiološke podatke in podatke o predpisovanju, ter computer-supported decisions, which link clinical indication, microbiological data and prescribing data together, and 0.6545454545454545 • zmanjšal pojav bolnišničnih okužb; Reducing the incidence of hospital-acquired infections, 1.2921348314606742 Spodbujajte proaktivne preglede in zagotavljanje povratnih informacij zdravnikom, ki predpisujejo zdravila [54,56]. Promote proactive audits and ensure that individual prescribers receive feedback [54,56]. 1.0978260869565217 a) ustanovitev interdisciplinarne skupine za program nadzora nad rabo antibiotikov v vaši bolnišnici. a) Establishing a multidisciplinary team for your hospital antibiotic stewardship programme. 1.223529411764706 Okrepite dejavnosti epidemiološkega spremljanja rabe antibiotikov in odpornosti proti antibiotikom [56]. Strengthen surveillance activities for antibiotic use and antibiotic resistance [56]. 1.04 b) podpiranje izvajanja smernic za rabo antibiotikov ter ukrepov za preprečevanje in obvladovanje okužb; b) Supporting implementation of antibiotic guidelines and infection prevention and control measures; 1.0711610486891385 Da bi bile skupine za nadzor nad rabo antibiotikov lahko uspešne, potrebujejo aktivno podporo drugih ključnih strokovnjakov v bolnišnicah, kot so strokovnjaki za preprečevanje in obvladovanje okužb, urgentni zdravniki, bolnišnični epidemiologi, negovalno osebje in osebje za IT [42,77]. For antibiotic stewardship teams to be successful, they need the active support of other key professionals in hospitals, such as infection prevention and control professionals, emergency department practitioners, hospital epidemiologists, nurses and IT staff [42,77]. 1.146788990825688 Prednostno obravnavajte nadzor nad rabo antibiotikov ter politiko preprečevanja in obvladovanja okužb, pa tudi strategije in dejavnosti, ki podpirajo preudarno rabo antibiotikov ter preprečujejo širjenje bakterij, odpornih proti antibiotikom [31,71]. Prioritise antibiotic stewardship and infection prevention and control policies, as well as strategies and activities that support prudent antibiotic use and prevent the spread of antibiotic-resistant bacteria [31,71]. 0.6818181818181818 • skrajšala hospitalizacija in Shortening the length of hospital stays, and 1.125 • uporaba hitrih diagnostičnih testov na mestu oskrbe. use of rapid and point-of-care diagnostic tests. 1.1686746987951808 f) zagotavljanje stalne razpoložljivosti antibiotikov v okviru bolnišničnega kataloga zdravil ter f) Ensuring that antibiotics listed in hospital formulary are always available; and 1.1161616161616161 Podprite svojo interdisciplinarno skupino za nadzor nad rabo antibiotikov z imenovanjem posebnih vodij, ki bodo odgovorni in strokovni v zvezi z zdravili, ter z opredelitvijo podpornih vlog drugih ključnih skupin [42,71]. Support your multidisciplinary antibiotic stewardship team by designating the specific leaders for accountability and drug expertise, and by stating the supportive roles of other key groups [42,71]. 1.2201834862385321 Povprašujejo po lokalnih smernicah za rabo antibiotikov, posebnih izobraževanjih in skupinah za nadzor nad rabo antibiotikov [25,27]. They are asking for local antibiotic guidelines, specific education and antibiotic stewardship teams [25,27]. 1.015625 Financirajte in spodbujajte izobraževalne dejavnosti, usposabljanja in srečanja na temo nadzora nad rabo antibiotikov in odpornosti proti antibiotikom za vse zdravstvene delavce (zdravnike, infektologe, farmacevte, mikrobiologe in negovalno osebje) [19,53,56]. Fund and promote educational activities, training, and meetings about antibiotic stewardship and antibiotic resistance for all healthcare professionals (physicians, infectious disease specialists, pharmacists, microbiologists and nursing staff) [19,53,56]. 1.051948051948052 S programi za nadzor nad rabo antibiotikov lahko skupaj s praksami preprečevanja in obvladovanja okužb povečamo varnost bolnikov in kakovost oskrbe ter zmanjšamo bolnišnične stroške pri vseh storitvah z izboljšanjem načina rabe antibiotikov ter zmanjšanjem okužb z bakterijo C. difficile in drugih neželenih učinkov [19,42]. Antibiotic stewardship programmes, together with infection prevention and control practices, can increase patient safety and quality of care and reduce hospital costs across all services by improving how antibiotics are used, as well as by decreasing C. difficile infections and other adverse events [19,42]. 0.821917808219178 Infektologi, klinični mikrobiologi in klinični farmacevti skupaj vodijo skupino za nadzor nad rabo antibiotikov [56,76]. Infectious disease specialists, clinical microbiologists, and clinical pharmacists are all key leaders in the antibiotic stewardship team [56,76]. 1.0887096774193548 • ukrepi prepričevanja vključujejo proaktivne revizije njihove rabe in povratne informacije infektologov, mikrobiologov in farmacevtov. Persuasive measures include proactive audit and feedback by infectious diseases physicians, microbiologists and pharmacists. 1.2027972027972027 Spodbujajte ravnanje v skladu s smernicami, ki temeljijo na dokazih, za ukrepe za obvladovanje okužb in s tem zmanjšanje prenosa bakterij, odpornih proti antibiotikom [82]. Promote compliance with evidence-based guidelines for infection control measures, to reduce transmission of antibiotic-resistant bacteria [82]. 1.56198347107438 d) spodbujanje zdravnikov, ki predpisujejo zdravila, in vodij skupin za nadzor nad rabo antibiotikov k sodelovanju in izvajanju proaktivnih revizij ter k zagotavljanju povratnih informacij; d) Promoting prescribers and antibiotic stewardship team leaders to collaborate and conduct proactive audit and feedback. 1.0719424460431655 g) zagotavljanje prednostne obravnave vprašanj preudarne rabe antibiotikov in preprečevanja odpornosti proti antibiotikom v letnem načrtu bolnišnice. g) Ensuring that prudent antibiotic use and prevention of antibiotic resistance are "priority action areas" in your hospital's annual plan. 0.9831932773109243 iv. izboljšujejo preprečevanje in obvladovanje bolnišničnih okužb ter širjenja bakterij, odpornih proti antibiotikom; iv. enhance prevention and control of healthcare-associated infections and the spread of antibiotic-resistant bacteria. 1.1746031746031746 upoštevajo vedenjske dejavnike, ki vodijo do neustrezne rabe antibiotikov; iii. address behavioural factors shaping misuse of antibiotics; 1.0267857142857142 S smernicami za rabo antibiotikov ter rednimi izobraževanji in vizitami se izboljšuje način zdravljenja okužb [78]. Antibiotic guidelines and regular educational sessions and rounds improve how physicians manage infections [78]. 1.0144927536231885 Spodbujajte medsebojno pregledovanje receptov za izdajo antibiotikov in zdravljenja okužb ter sporazumevanje med zdravstvenimi delavci [71]. Promote peer-review of antibiotic prescriptions and infection management, and encourage communication among healthcare professionals [71]. 1.203125 zagotavljajo upoštevanje priporočil programa za nadzor nad rabo antibiotikov; ensure that antibiotic stewardship recommendations are followed; 1.091549295774648 Spodbujajte ravnanje v skladu s smernicami, ki temeljijo na dokazih, za diagnosticiranje in zdravljenje pogostih okužb in kirurške antibiotične profilakse. Promote compliance with evidence-based guidelines for diagnosing and managing common infections, and for perioperative antibiotic prophylaxis. 0.6145251396648045 z osebnimi dohodki za namensko osebje, IT zmogljivostmi in hitrimi diagnostičnimi testi na mestu oskrbe) [31]. Provide funds and resources for an antibiotic stewardship programme (including e.g., salaries for dedicated staff, IT capabilities, rapid and point-of-care diagnostic tests) [31]. 1.141732283464567 Spodbujajte pripravo smernic ter empirično izbiro antibiotikov na osnovi lokalnih mikrobioloških rezultatov in odpornosti proti antibiotikom[31]. Promote using local microbiology and antibiotic resistance patterns to inform guidelines and empirical antibiotic choices [31]. 1.0114942528735633 Vsako leto zaradi okužbe z bakterijami, odpornimi proti antibiotikom, umre 33 000 ljudi. Each year, 33000 people die from an infection due to bacteria resistant to antibiotics. 1.1538461538461537 V skoraj polovici primerov je uporaba antibiotikov v bolnišnicah nepotrebna in neprimerna. Up to half of all antibiotic use in hospitals is unnecessary of inappropriate. 0.6712328767123288 v bolnišnicah in ustanovah za dolgotrajno oskrbo. Communicating to professionals in hospitals and long-term care facilities 1.1866666666666668 Napačna uporaba antibiotikov v bolnišnicah je glavni vzrok odpornosti proti antibiotikom. Antibiotic misuse in hospitals is a major driver of antibiotics resistance. 1.0666666666666667 slovenščina (sl) See infographic 0.5384615384615384 EVROPSKA POBUDA NA PODROCJU ZDRAVJA European Antibiotics Awareness Day, a European Health Initiative. 0.9038461538461539 f) spremljanje stanja bolnikov 24 ur na dan ter f) Monitoring patient status on a 24 hour basis; and 0.896 d) omogočanje sporazumevanja med zdravniki, lekarno, laboratorijem, načrtovalci odpustov, svetovalci in bolniki; d) Facilitating communication between physicians, the pharmacy, the laboratory, discharge planners, consultants and patients; 0.8240740740740741 b) usklajevanje odvzemanja in pošiljanja mikrobioloških vzorcev ter poročanje zdravnikom; b) Coordinating the taking and sending of microbiological specimens, and their reporting back to physicians; 1.125 e) zagotavljanje informacij o zdravljenju bolnikom in družinskim članom; e) Providing information on treatments to patients and families; 0.9932432432432432 Redno sodelujte pri usposabljanjih in na srečanjih o preudarni rabi antibiotikov, zbiranju vzorcev ter preprečevanju in obvladovanju okužb [53,96]. Participate regularly in training courses and meetings on prudent antibiotic use, specimen collection, and infection prevention and control [53,96]. 1.0886075949367089 Obvestite zdravnika, ki predpisuje zdravila, ali farmacevta, če ugotovite, da se bolnik zdravi z antibiotiki že več kot sedem dni brez določenega trajanja zdravljenja [69]. Inform the prescriber or pharmacist if you see a patient has an antibiotic prescription which has continued beyond seven days without specified duration [69]. 1.09009009009009 g) vodenje zalog antibiotikov na svojem oddelku in zagotavljanje sledljivosti uporabe antibiotikov [strokovno usklajeno]. g) Managing antibiotic stocks on your ward, and ensuring the traceability of antibiotic use [expert consensus]. 1.2117647058823529 Poskrbite, da bodo bolniki (in njihovi družinski člani) razumeli razloge za zdravljenje z antibiotiki ter ključne točke v zvezi z njihovo uporabo, pri čemer jih opozorite, naj [31,69] [strokovno usklajeno]: Ensure that patients (and their families) understand the reason for antibiotic therapy, and key points related to antibiotic use, including to [31,69] [expert consensus]: 1.0470588235294118 Vaše naloge v zvezi z izboljšanjem rabe antibiotikov so [31,96,97] [strokovno usklajeno]: Your tasks related to improving antibiotic use include [31,96,97] [expert consensus]: 1.45 f) antibiotikov nikoli ne shranjujejo za poznejšo uporabo; f) Never save antibiotics for later use; 1.547008547008547 Spodbujajte zdravnike, ki predpisujejo zdravila, naj za vse bolnike, ki se zdravijo z antibiotiki, po 48-72 urah dokumentirajo svojo odločitev na podlagi ponovne presoje [31,42,69]. Prompt prescribers to document their reviewing decision for all patients on antibiotics after 48-72 hours [31,42,69]. 1.0505050505050506 c) poročanje o neželenih učinkih zdravljenja z antibiotiki zdravnikom in ustreznim nadzorom za preglede; c) Reporting adverse effects of antibiotic therapy to physicians and appropriate review committees; 1.1047619047619048 Upoštevajte ukrepe za preprečevanje in obvladovanje okužb, ki so vzpostavljeni v vašem okolju [strokovno usklajeno]. Follow infection prevention and control measures that are established in your setting [expert consensus]. 1.088 Poskrbite, da se pred zdravljenjem z antibiotiki ustrezne kužnine pravilno odvzamejo in pošljejo v mikrobiološki laboratorij [31,42,70]. Ensure that cultures are appropriately taken and send to the microbiology laboratory, before starting antibiotics [31,42,70]. 0.7887323943661971 a) odmerjanje antibiotikov bolnikom v skladu z navodili; a) Administering antibiotics to patients according to the prescription; 0.9387755102040817 V sodelovanju z zdravniki in farmacevti izboljšujete prakso odmerjanja antibiotikov [96,97]. Improve antibiotic administration practices in collaboration with doctors and pharmacists [96,97]. 1.0686274509803921 Zagotovite, da se o laboratorijskih izvidih takoj obvesti zdravnika, ki zdravi bolnika [strokovno usklajeno]. Ensure that laboratory results are promptly communicated to the treating physician [expert consensus]. 1.2522522522522523 Ste na ključnem položaju, ki vam omogoča, da v sodelovanju s skupino za nadzor nad rabo antibiotikov izboljšate kakovost njihove rabe [96]. You are in a key position to improve antibiotic use by collaborating with the antibiotic stewardship team [96]. 1.2698412698412698 g) nikoli ne uporabljajo antibiotikov, ki so jim ostali od preteklih zdravljenj; g) Never use leftover antibiotics from previous treatments; and 1.1481481481481481 h) antibiotikov, ki so jim ostali, nikoli ne delijo z drugimi. h) Never share leftover antibiotics with other people. 1.0476190476190477 e) antibiotike jemljejo v skladu z navodili; e) Take antibiotics exactly as prescribed; 1.5 • izobraževanjem osebja; staff education, 0.9444444444444444 Ključne naloge za izboljšanje rabe antibiotikov na vašem oddelku so: Core tasks to improve the use of antibiotics in your department include: 1.44 • praksami, ki temeljijo na dokazih; evidence-based practices, 1.0375 Izvajanje strategij za preprečevanje in obvladovanje okužb, vključno z [86,87,105]: Implementing infection prevention and control strategies, including [86,87,105]: 1.173913043478261 Izogibajte se nepotrebni antibiotični profilaksi [31]. Avoid unnecessary antibiotic prophylaxis [31]. 1.2419354838709677 Ključna sporočila za oddelek za intenzivno zdravljenje [zdravniki in vodstvo] Key messages for intensive care unit - physicians and managers 0.8275862068965517 Kako dolgo bi moral bolnik prejemati antibiotik? For how long should the patient receive the antibiotic(s)? 1.0087719298245614 Zdravljenje z antibiotiki začnite samo, če obstajajo dokazi o bakterijski okužbi, in ne zdravite kolonizacije [31]. Only start antibiotic treatment if there is evidence of a bacterial infection, and do not treat colonisation [31]. 1.25 Z omejevanjem oziroma racionalizacijo zdravljenja z antibiotiki dobimo boljše rezultate za bolnike [106]. Narrowing or streamlining antibiotic therapy leads to better patient outcomes [106]. 1.056910569105691 Organiziranje rednih interdisciplinarnih vizit osebja in obravnav primera za izboljšanje kakovosti zdravljenja z antibiotiki [72]. Organising regular multidisciplinary staff rounds and case discussions to improve the quality of antibiotic treatment [72]. 0.6923076923076923 Pri bolnikih s sepso čim prej začnite intravensko zdravljenje z antibiotiki [90]. For patients with sepsis, initiate effective antibiotic treatment via the intravenous route as soon as possible [90]. 1.225 a) z upoštevanjem protokola za oskrbo prek osrednjega katetra (za vstavljanje in vzdrževanje) se zmanjša število okužb krvnega obtoka, povezanih z osrednjim katetrom, na vseh oddelkih za intenzivno zdravljenje (za odrasle in novorojenčke) [107]; a) Complying with a central-line care protocol (for insertion and maintenance), reduces central-line-associated bloodstream infections in all types of intensive care units (adults and neonatal) [107]. 0.8909090909090909 Z upoštevanjem ukrepov za preprečevanje in obvladovanje okužb se zmanjša pojav bolnišničnih okužb. Following infection prevention and control measures reduces the incidence of healthcare-associated infections. 1.2013888888888888 Redno sodelovanje pri izobraževalnih dejavnostih ter proaktivno pregledovanje in posredovanje povratnih informacij, skupaj s skupino za nadzor nad rabo antibiotikov [54,56]. Participating in education activities regularly, as well as proactive audits and feedback together with the antibiotic stewardship team [54,56]. 0.7887323943661971 • vzpostavljanjem sistemov za nadzor bolnišničnih okužb. establishing surveillance systems for healthcare-associated infections. 1.4444444444444444 • nadaljuje oziroma konča zdravljenje z antibiotiki; continue or stop antibiotic therapy; 1.1185185185185185 Upoštevajte protokole za zdravljenje z antibiotiki na podlagi z dokazi podprtih smernic, ki so vzpostavljene v vašem okolju [31] [strokovno usklajeno]. Follow antibiotic treatment protocols, based on evidence-based guidelines that are established in your setting [31] [expert consensus]. 1.0344827586206897 Seznanjenost z odpornostjo proti antibiotikom na vašem oddelku, v bolnišnici in skupnosti [31,72] [strokovno usklajeno]. Remain aware of local antibiotic resistance patterns in your department, your hospital and in the community [31,72]. 1.101063829787234 Skupaj s skupino za preprečevanje in obvladovanje okužb upoštevajte navodila (smernice, protokole in kontrolne sezname) za uvedbo ukrepov za preprečevanje in obvladovanje okužb [86,87] [strokovno usklajeno]. Implement guidance (guidelines, protocols and checklists) for infection prevention and control measures, together with the infection prevention and control team [86,87] [expert consensus]. 0.9868421052631579 Ali bi se lahko za zdravljenje okužbe uporabil antibiotik z ožjim spektrom? Could an antibiotic with a narrower spectrum be used to treat the infection? 1.0714285714285714 i. Ali je bil bolniku predpisan ustrezen antibiotik, ustrezen odmerek in ustrezen način dajanja zdravila? i. Is the patient on the correct antibiotic(s), correct dose, and correct route of administration? 1.0859375 Poskrbite, da se pred zdravljenjem z antibiotiki ustrezne kužnine pravilno odvzamejo in pošljejo v mikrobiološki laboratorij [31,42,70,71]. Ensure that cultures are appropriately taken and send to the microbiology laboratory, before starting antibiotics [31,42,70,71]. 0.7638888888888888 Ko predpisujete antibiotik, temeljito preverite anamnezo bolnika, vključno z nedavno rabo antibiotikov, alergijami na zdravila, uporabo imunosupresivnih zdravil in dejavniki tveganja za odpornost proti antibiotikom (npr. Take a thorough patient history when you prescribe an antibiotic, including recent antibiotic use, drug allergies, use of immunosuppressive therapy, and risk factors for antibiotic resistance (for example, recent hospitalisation, recent procedure or recent travel outside of Europe) [31]. 0.9276315789473685 V bolnikovi kartoteki dokumentirajte zdravljenje z antibiotiki, vrsto zdravila, način dajanja zdravila in trajanje zdravljenja [31,42,70,71]. Document the indication of antibiotic treatment, drug choice, dose, route of administration and duration of treatment in the patient chart[31,42,70,71]. 1.0657894736842106 Ponovna presoja o zdravljenju z antibiotiki glede na klinično stanje po 48-72 urah oziroma takoj, ko postanejo znani mikrobiološki rezultati, da se [31,42,70-72]: Reassessing antibiotic treatments in light of clinical conditions at 48-72 hours, or as soon as microbiological results are available, to [31,42,70-72]: 1.205128205128205 • preide na jemanje antibiotika ožjega spektra; change to a narrow-spectrum antibiotic; 1.411764705882353 • preide na peroralno zdravljenje z antibiotiki. switch to oral antibiotic therapy. 0.94 1. upoštevanje protokolov zdravljenja z antibiotiki na podlagi z dokazi podprtih smernic (npr. Following antibiotic treatment protocols, based on evidence-based guidelines (e.g. for sepsis) [90]. 0.45714285714285713 slovenščina (sl) ​Council of European Dentists (CED) 0.8333333333333334 EVROPSKA POBUDA NA PODROCJU ZDRAVJA European Federation of Nurses Associations 1.4565217391304348 informativno gradivo, komplet informativnega gradiva, videoposnetek information material, poster, toolkit material 1.0869565217391304 1 od 3 bolnikov je na dnevni ravni prejel vsaj eno antimikrobično zdravilo. 1 in 3 patients received at least one antimicrobial on any given day. 1.173913043478261 Uporaba antimikrobikov v evropskih bolnišnicah in ustanovah za dolgotrajno oskrbo Antimicrobial use in European hospitals and long-term care facilities 1.1833333333333333 Odpornost proti antibiotikom - čedalje večja nevarnost za zdravje ljudi Antibiotic resistance - an increasing threat to human health 1.3628318584070795 Ocenjuje se, da se v evropskih bolnišnicah in ustanovah za dolgotrajno oskrbo vsako leto pojavi skupno 8,9 milijona okužb, povezanih z zdravstveno oskrbo. A total of 8.9 million HAIs were estimated to occur each year in European hospitals and long-term care facilities 1.6790123456790123 Breme okužb z bakterijami, odpornimi proti antibiotikom, je primerljivo tistemu, ki ga povzročajo gripa, tuberkuloza in HIV/aids skupaj. The burden is comparable to that of influenza, tuberculosis and HIV/AIDS combined. 1.0422535211267605 Okužbe, povezane z zdravstveno oskrbo, ogrožajo varnost evropskih bolnikov Healthcare-associated infections - a threat to patient safety in Europe 2.1538461538461537 grafični prikaz informacij - infographic - 0.5733333333333334 Odpornost proti mikrobom v Evropi leta 2014 Overview of the data on antimicrobial resistance in Europe released in 2014 0.8235294117647058 Ključna sporočila za klinične mikrobiologe Infographic about antibiotic stewardship programmes 0.8390804597701149 Zagotavljanje prednostne obravnave vprašanj preudarne rabe antibiotikov in preprečevanja odpornosti proti antibiotikom v letnem načrtu bolnišnice. This infographic highlights the threat that antibiotic resistance poses and the effectiveness of antibiotic stewardship programmes to address the issue from different angles. 1.1 Na ravni prebivalstva: At population level: 0.8833333333333333 Gre za prilagoditev mikroorganizma na njegovo okolje. It is an adaptation of the microorganism to its environment. 0.953125 Pojma se sicer močno razlikujeta, vendar se zaradi skupnih razvojnih in strokovnih značilnosti pogosto obravnavata skupaj. The two concepts are thus really quite separate, but for historical and professional reasons they are often dealt with together. 1.0132450331125828 V Franciji in Belgiji je to zmanjšanje mogoče pripisati nacionalnim ukrepom, vključno z letno vsedržavno javno kampanjo o preudarni uporabi antibiotikov; In France and Belgium, the decrease was attributed to national action including a yearly, nationwide public campaign on the prudent use of antibiotics; 0.9808917197452229 iz Francije, Belgije, Slovaške, Češke republike, Slovenije in s Švedskega) so nedavno poročali o zmanjšanju uporabe antibiotikov pri ambulantnih bolnikih; Six Member States (i.e. France, Belgium, Slovakia, Czech Republic, Slovenia and Sweden) recently reported decreasing trends in antibiotic use in outpatients; 0.9023255813953488 Ta novi trend je zaskrbljujoč, saj se trenutno raziskuje in razvija le malo spojin, ki bi utegnile učinkovati proti tem bakterijam in bi jih bilo mogoče dati v promet v naslednjih 5 do 10 letih. This new trend is worrying since there are very few compounds in the research and development pipeline that would potentially have an activity against these bacteria and could be marketed within the next 5-10 years. 0.8115942028985508 Bolnišnične okužbe so okužbe, pridobljene v bolnišnicah. Nosocomial infections correspond to infections acquired in hospitals. 1.0396039603960396 Dve glavni področji obvladovanja, nadzora in preprečevanja odpornosti na protimikrobna zdravila sta zato: The two major areas for management, control and prevention of antimicrobial resistance therefore are: 1.0662650602409638 Obstajajo tudi precejšnje razlike v uporabi antibiotikov med državami članicami EU, kot je razvidno iz podatkov Evropskega programa za spremljanje porabe protimikrobnih zdravil. There are also large variations in antibiotic use among EU Member States, as shown by data from the European Surveillance of Antimicrobial Consumption (ESAC) project; 0.8191489361702128 To je edini primer, ko je sistemske antibiotike mogoče izdajati brez recepta. This is the only exception where systemic antibiotics can be dispensed without a prescription. 1.0104166666666667 Nekatere bakterije so naravno odporne na nekatere antibiotike (notranja ali prirojena odpornost). Some bacteria are naturally resistant to certain antibiotics (intrinsic or inherent resistance). 1.0284090909090908 Iz letnega poročila EARSS za leto 2007 je razvidno, da iz sedmih držav članic zdaj poročajo o bistvenem zmanjšanju deleža MRSA seva Staphylococcus aureus pri okužbah krvnega obtoka. The EARSS Annual Report 2007 indicated that seven Member States now report significantly decreasing percentages of MRSA among Staphylococcus aureus from bloodstream infections. 1.0891089108910892 Medtem ko v državah v razvoju ljudje umirajo zaradi pomanjkanja ustreznega zdravljenja s protimikrobnimi zdravili, je odpornost na protimikrobna zdravila zaradi neustrezne uporabe razlog za zaskrbljenost na vseh celinah; While people die in developing countries because they lack access to the correct antimicrobial treatment, antimicrobial resistance resulting from inappropriate use is causing concern in every continent; 1.0224719101123596 Skupna stopnja odpornosti na protimikrobna zdravila pri vseh prenosljivih boleznih, ki jih navaja odločba Komisije 2000/96/ES, (vključno z bolnišničnimi okužbami), trenutno ni znana. The total burden of antimicrobial resistance across all the communicable diseases listed in Commission Decision 2000/96/EC (including nosocomial infections) is currently unknown. 0.9776119402985075 Poleg tega se v EU trenutno pojavljajo tudi primeri okužb z bakterijami, ki so v celoti ali skoraj v celoti odporne na antibiotike. Additionally, cases of infections due to bacteria totally or almost totally resistant to antibiotics are currently emerging in the EU. 1.3958333333333333 Odpornost na protimikrobna zdravila je težava globalne razsežnosti. Antimicrobial resistance is a worldwide problem. 1.0574712643678161 Mikroorganizmi - imenovani tudi mikrobi - vključujejo bakterije, viruse, glive in zajedavce. Microorganisms - also called microbes - include bacteria, viruses, fungi and parasites. 0.9311594202898551 Od oktobra 2008 lahko bolniki v Združenem kraljestvu, ki so asimptomatični, vendar je bila pri njih diagnosticirana genitalna okužba s klamidijo, v lekarnah (brez recepta) dobijo enkratni odmerek antibiotika azitromicina, ki predstavlja celotno zdravljenje. Since October 2008, it is possible for patients in the UK who are asymptomatic but who have a diagnosed genital infection with Chlamydia to obtain from pharmacists (without a prescription) a single dose of the antibiotic azithromycin, representing a complete treatment course. 1.1405405405405404 Kadar se pojavijo in nastanejo na antibiotike odporne bakterije, so previdnostni ukrepi za nadzor okužb bistvenega pomena za preprečevanje širjenja okužbe z nosilcev okuženih bolnikov na druge bolnike ali osebe. Whenever antibiotic-resistant bacteria emerge and develop, infection control precautions are essential to prevent spread from carriers of infected patients to other patients or persons. 1.0411764705882354 Izziv pri mikroorganizmih, odpornih na več zdravil, je, da je na voljo le omejeno število preostalih možnosti (če sploh) za zdravljenje bolnikov, okuženih s temi mikroorganizmi. The challenge with multidrug-resistant microorganisms lies in the limited number of remaining options (if any) for therapy of patients infected with these microorganisms. 1.0347490347490347 Po predhodnih ocenah predstavlja delež smrti, ki ga je mogoče neposredno pripisati bolnišničnim okužbam z najpogostejšimi glavnimi bakterijami, odpornimi na več zdravil, 1/3 do 1/2 vseh smrti zaradi bolnišničnih okužb nasploh (glejte spodaj) (ECDC, predhodni podatki). Preliminary estimates of the number of deaths directly attributable to hospital-acquired infections due to the most common major multidrug-resistant bacteria are 1/3 to 1/2 of that for hospital-acquired infections overall (see below) (ECDC, preliminary data). 1.3539823008849559 Del bremena odpornosti na protimikrobna zdravila v EU je mogoče pripisati protimikrobnim učinkovinam, ki se uporabljajo pri živalih za proizvodnjo živil. Part of the burden of antimicrobial resistance in the EU is due to antimicrobials used in food-producing animals. 0.973384030418251 Kljub tem spodbudnim izkušnjam je odpornost na protimikrobna zdravila še vedno visoka oz. narašča v večini držav članic, zlasti pri pogostih bakterijah, kot so Staphylococcus aureus (MRSA), Escherichia coli, Klebsiella pneumoniae in Pseudomonas aeruginosa. Despite these encouraging experiences, antimicrobial resistance still is high or increasing in a majority of Member States, in particular for common bacteria such as Staphylococcus aureus (MRSA), Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. 1.1564245810055866 Bolj zaskrbljujoča težava nastane, ko nekatere bakterije, ki so v normalnih okoliščinah občutljive na antibiotike, postanejo odporne zaradi prilagajanja na podlagi genetskih sprememb (pridobljena odpornost). A more worrying problem is when some bacteria that are normally susceptible to antibiotics become resistant as a result of adaptation through genetic change (acquired resistance). 0.9014778325123153 Poleg tega se lahko v človeškem telesu geni, ki kodirajo odpornost na antibiotike pri določeni vrsti bakterij, enostavno širijo na druge vrste bakterij z izmenjavo genskega materiala. Additionally, within the body of a human being, the genes coding for antibiotic resistance in one species of bacteria can easily spread to other bacterial species through an exchange of genetic material. 1.1354166666666667 Ko se bakterije, odporne na antibiotike, ustalijo v človeškem telesu, se lahko širijo na drugo osebo, pri čemer visoka poraba antibiotikov v dani populaciji (v bolnišnicah ali skupnosti) močno spodbuja takšno širjenje. Once established in a person, antibiotic-resistant bacteria can spread to another person and a high antibiotic consumption in a population (hospital or community) strongly favours such spread. 0.9166666666666666 širjenje in navzkrižno prenašanje na protimikrobna zdravila odpornih mikroorganizmov med ljudmi, živalmi ter med ljudmi in živalmi ter okoljem. Spread and cross-transmission of antimicrobial-resistant microorganisms between humans, between animals, and between humans and animals and the environment. 0.9298245614035088 Ljudje in živali ne postanejo odporni na protimikrobna zdravila, temveč bakterije in drugi mikroorganizmi. Humans and animals do not become resistant to antimicrobial treatments, but bacteria and other microorganisms can. 0.911504424778761 Te odporne bakterije se lahko ohranijo do šest mesecev in včasih tudi dlje, ne da bi povzročile okužbo; These resistant bacteria may persist, generally without causing infection, up to six months and sometimes longer; 0.9154929577464789 Sodobno zdravstvo je odvisno od razpoložljivosti učinkovitih antibiotikov v primeru zapletov zaradi okužb ali za profilakso okužb. Modern medicine relies on availability of effective antibiotics in the case an infectious complication occurs or for prophylaxis of infection. 1.1565217391304348 Bakterije postanejo odporne na antibiotike, ko posamezni antibiotiki izgubijo sposobnost, da jih ubijejo ali zaustavijo njihovo rast. Bacteria have antibiotic resistance when specific antibiotics have lost their ability to kill or stop their growth. 0.8666666666666667 Nasprotno mnoge bolnišnične okužbe povzročajo mikroorganizmi, ki niso odporni na protimikrobna zdravila. Conversely, many healthcare-associated infections are caused by microorganisms that are not resistant to antimicrobials. 0.779891304347826 odpornost na enega ali več protimikrobnih zdravil, ki se uporabljajo za zdravljenje ali profilakso, ni bolezen, temveč značilnost, ki jo je načeloma mogoče pripisati vsakemu mikroorganizmu, ki povzroča prenosljive bolezni, navedene v odločbi Komisije 2000/96/ES, ter bolnišnične bolezni. Antimicrobial resistance, i.e. being resistant to one or several antimicrobials used for therapy or prophylaxis, is not a disease but a characteristic that may apply, as a matter of principle, to each of the microorganisms responsible for the communicable diseases listed in Commission Decision 2000/96/EC and for nosocomial and other healthcare-associated infections. 1.063953488372093 higienski previdnostni ukrepi za nadzor navzkrižnega prenašanja na protimikrobna zdravila odpornih mikroorganizmov (nadzor okužb), vključno s higieno rok, presejanjem, osamitvijo itd. Hygienic precautions for the control of cross-transmission of antimicrobial-resistant microorganisms (infection control), including hand hygiene, screening, isolation, etc. 0.9172661870503597 Popotniki, ki potrebujejo bolnišnično oskrbo med obiskom države z visoko odpornostjo na protimikrobna zdravila, znotraj ali zunaj EU, in ki so nato napoteni v domovino, so lahko ob vrnitvi kolonizirani ali celo okuženi z bakterijo, odporno na več zdravil. Travellers that require hospital care while visiting a country with high prevalence of antimicrobial resistance, within or outside of the EU, and who are subsequently repatriated to their home country, may return being colonised or even infected by multidrug-resistant bacteria. 1.0512820512820513 Protimikrobna zdravila so zdravila, ki ubijajo žive mikroorganizme oz. zaustavljajo njihovo rast in vključujejo med drugim: Antimicrobials are medicinal products that kill or stop the growth of living microorganisms and include among others: 1.0508474576271187 uporaba protimikrobnih učinkovin, ki povzroča ekološki pritisk na mikroorganizme ter prispeva k nastanku in ohranitvi na protimikrobna zdravila odpornih mikroorganizmov med populacijami; Use of antimicrobials, which exerts an ecological pressure on microorganisms and contributes to emergence and selection of antimicrobial-resistant microorganisms in populations; 1.0238095238095237 Iz letnega poročila EARSS za leto 2007 ter nacionalnih podatkov je razviden trend zmanjševanja odpornosti Streptococcus pneumoniae, bakterije, ki pogosto povzroča okužbe pri ambulantnih bolnikih, zlasti pri otrocih; The EARSS Annual Report 2007, as well as national data, indicated decreasing resistance trends in Streptococcus pneumoniae, a bacteria commonly responsible for infections in outpatients, in particular children; 0.9430379746835443 Mikroorganizmi, ki kolonizirajo in včasih okužijo ljudi in živali, so tisti, ki postanejo odporni na protimikrobna zdravila, ne pa ljudje ali živali. It is the microorganisms that colonise and sometimes infect humans and animals which become resistant to antimicrobials, not the humans or animals themselves. 0.83125 V nekaterih državah je zmanjševanje odpornosti opaziti tudi pri enem mikroorganizmu, ki povzroča bolnišnične okužbe, namreč pri MRSA. In a few countries, decreasing trends in resistance are also being observed for one microorganism responsible for healthcare-associated infections, namely MRSA. 0.8314176245210728 Te pozitivne izkušnje nekaterih držav članic EU predstavljajo ozadje evropskega dneva ozaveščanja o antibiotikih, kampanje, katere namen je zmanjšati uporabo antibiotikov v primerih, kadar ti niso nujno potrebni, npr. These positive experiences from some EU Member States are the background for the European Antibiotic Awareness Day, a campaign to reduce use of antibiotics in situations where they are not necessary, for example for viral infections such as colds and influenza. 1.1224489795918366 Vse bakterije, ki so odporne na antibiotike, preživijo tudi ob prisotnosti antibiotikov in se še naprej širijo, kar podaljša trajanje bolezni ali povzroči celo smrt. All antibiotic-resistant bacteria survive in the presence of the antibiotic and continue to grow and multiply causing longer illness or even death. 1.1841004184100419 Antibiotiki, ki se uporabljajo za zdravljenje in preprečevanje okužb pri živalih, sodijo v iste kemijske skupine kot antibiotiki, ki se uporabljajo pri ljudeh, zato so lahko v živalih prisotne bakterije, odporne na antibiotike, ki se uporabljajo tudi za zdravljenje okužb pri ljudeh; Antibiotics used to treat and prevent infections in animals belong to the same chemical groups as those used in human medicine, therefore animals may carry bacteria that are resistant to antibiotics also used to treat infections in humans; 1.1287128712871286 Brez učinkovitih antibiotikov intenzivna nega, presaditev organov, kemoterapija pri zdravljenju rakavih obolenj in nega nedonošenčkov ne bi bile mogoče, prav tako ne običajni operativni posegi, kot je zamenjava kolka ali kolena. Without effective antibiotics, intensive care, organ transplants, cancer chemotherapy, care of preterm babies, or even common surgical procedures, such as hip or knee replacement, would not be possible. 0.8620689655172413 Povzročajo tudi okužbe ter jih je mogoče osamiti iz živali za proizvodnjo živil oz. včasih iz hrane. They are also responsible for infections and isolated from food-producing animals and sometimes isolated from foods. 1.07 Vendar pa je glavni razlog za odpornost na protimikrobna zdravila pri mikroorganizmih pri ljudeh uporaba protimikrobnih zdravil v humani medicini, zunaj bolnišnic ter v bolnišnicah in drugih zdravstvenih ustanovah. However, the major cause of antimicrobial resistance in microorganisms from humans remains the use of antimicrobials in human medicine, in the community and in hospitals and other healthcare settings. 1.1620689655172414 Obstajajo precejšnje razlike v deležih odpornih bakterij med državami EU, in sicer je te razlike (pogosto gre za zmanjševanje deleža od severa proti jugu) mogoče opaziti pri večini bakterij, odpornih na protimikrobna zdravila, ki so bile preučevane v okviru evropskega sistema za spremljanje odpornosti na protimikrobna zdravila (EARSS); There are large intercountry variations in the proportions of resistant bacteria in the EU and these variations, often showing a North-to-South gradient, can be observed for most antimicrobial-resistant bacteria surveyed by the European Antimicrobial Resistance Surveillance System (EARSS); 0.9906103286384976 Ker se na protimikrobna zdravila odporni mikroorganizmi ne odzovejo na zdravljenje, lahko okužbe s temi mikroorganizmi predstavljajo večje tveganje smrti ter podaljšanja trajanja bolezni in bivanja v bolnišnici. Because antimicrobial-resistant microorganisms fail to respond to therapy, infections due to these microorganisms result in greater risk of death, prolonged illness and stay in hospitals and greater risk of death. 0.9629629629629629 Odpornost na protimikrobna zdravila zmanjša ali izniči učinkovitost protimikrobne učinkovine pri zdravljenju ali preprečevanju okužbe s tem mikroorganizmom. Antimicrobial resistance results in a reduction or elimination of effectiveness of the antimicrobial agent to cure or prevent infection due to this microorganism. 0.9137055837563451 To je najverjetneje rezultat povečanih prizadevanj za nadzor okužb, higiene rok in strategije rabe antibiotikov v bolnišnicah v teh državah, kot so pokazali nacionalni podatki npr. This is likely due to increased efforts on infection control, hand hygiene and antibiotic policy in hospitals in these countries as demonstrated by national data from, e.g. Slovenia, France and UK. 1.103658536585366 Zaradi izpostavljenosti antibiotikom sta lahko v živalih prisotni na protimikrobna zdravila odporni bakteriji Salmonella in Campylobacter, ki se preneseta z živali na ljudi s hrano; Because of exposure to antibiotics, animals may carry antimicrobial-resistant Salmonella and Campylobacter that are transferred from animals to humans through food; 1.0384615384615385 Pri bakterijah pomeni odpornost na antibiotike sposobnost bakterij, da so odporne na delovanje antibiotikov. For bacteria, antibiotic resistance is the ability of bacteria to resist to the action of an antibiotic. 0.7902621722846442 Svetovna zdravstvena organizacija (SZO) je izdala globalno strategijo in smernice za pomoč državam pri vzpostavljanju sistemov za spremljanje odpornosti na protimikrobna zdravila in pri ustreznem ukrepanju, npr. The World Health Organization (WHO) has issued a global strategy and guidelines to help countries in setting up systems to monitor antimicrobial resistance and implement interventions, e.g. to ensure that antibiotics can only be purchased with a medical prescription. 1.0307692307692307 Na protimikrobna zdravila odporne bakterije se lahko prenesejo na ljudi tudi ob neposrednem stiku z živalmi, tako kot se prenašajo nekateri sevi MRSA, ki so včasih osamljeni iz živine, zlasti prašičev. Humans may also acquire antimicrobial-resistant bacteria from direct contact with animals as this is the case with certain MRSA strains sometimes isolated from livestock, in particular from pigs. 0.8666666666666667 Kljub temu se v mnogo državah članicah protimikrobna zdravila še vedno izdajajo v lekarnah brez recepta. Despite this, dispensation of antimicrobials without a prescription still occurs at pharmacies in several Member States. 1.0538461538461539 Tudi pri ustrezni uporabi antibiotikov se lahko včasih pojavi odpornost na antibiotike kot naraven odziv bakterij v procesu prilagajanja. Even when antibiotics are used appropriately, antibiotic resistance sometimes develops as a natural adaptive reaction of bacteria. 1.1988304093567252 Pri zdravljenju bakterij, odpornih na antibiotike, utegne biti potrebno intravensko dajanje antibiotikov v bolnišnici namesto dajanja antibiotikov za peroralno uporabo, ki bi jih bolniki lahko jemali doma. Treatment of antibiotic-resistant bacteria may also require intravenous antibiotics given in hospitals instead of oral antibiotics that could be taken by patients at home. 0.8961038961038961 To vprašanje odpornosti na več zdravil je skupno vsem mikroorganizmom, vključno z bakterijami, ki povzročajo bolnišnične okužbe, mikroorganizmi, ki povzročajo bolezni, ki se prenašajo s hrano in vodo, tuberkulozo, ter mikroorganizmi, ki širijo spolno prenosljive bolezni, npr. This issue of multidrug resistance is relevant for all microorganisms, including bacteria responsible for healthcare-associated infections, microorganisms responsible for food- and waterborne infections, tuberculosis, and microorganisms responsible for sexually-transmitted diseases, e.g. gonorrhoea and HIV. 1.2658227848101267 protibakterijska zdravila (pogosto imenovana antibiotiki, ki učinkujejo proti bakterijskim okužbam), Antibacterials (often called antibiotics, active against bacterial infections), 0.73828125 Grčija in Ciper, ki uporabijo največ antibiotikov za ambulantno zdravljenje približno trikrat več antibiotikov na prebivalca letno kot države članice, ki uporabijo najmanj antibiotikov, tj. Once controlled for size of population, the Member States that use the most antibiotics for outpatients, i.e. Greece and Cyprus, use approximately three times more per inhabitant and per year than the Member State that uses the least, i.e. the Netherlands; 1.1098265895953756 Okužbe, ki jih povzročajo bakterije, odporne na antibiotike, utegnejo zahtevati več pozornosti ter zdravljenje z drugačnimi in dražjimi antibiotiki, ki utegnejo imeti resnejše neželene učinke. Infections caused by antibiotic-resistant bacteria may require more care as well as alternative and more expensive antibiotics, which also may have more severe side effects. 1.1920529801324504 V nenehnem boju za „ekološki prostor" se v naravnem izboru ohranijo vse odporne bakterije, medtem ko antibiotik ubije tiste bakterije v njihovih okolici, ki so še vedno občutljive. In the continuous fight for "ecological space", all resistant bacteria are selected as the antibiotic kills the still-susceptible bacteria around them. 0.7322580645161291 Bolnišnične okužbe in odpornost na protimikrobna zdravila sta dva posebna zdravstvena problema, navedena v Prilogi 1 k Odločbi Komisije 2000/96/ES z dne 22. decembra 1999 o nalezljivih boleznih, ki jih bo v skladu z Odločbo št. Nosocomial infections and antimicrobial resistance are two special health issues listed in Annex 1 of Commission Decision 2000/96/EC of 22 December 1999 on the communicable diseases to be progressively covered by the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. 0.8753799392097265 Mikroorganizmi, odporni na protimikrobna zdravila, vključno s sevi, ki so odporni na več zdravil, pogosto povzročajo bolnišnične okužbe, poleg tega pa tudi okužbe pri bolnikih zunaj bolnišnic; nahajajo se v normalni bakterijski flori zdravih posameznikov, hišnih ljubljenčkov in v okolju. Antimicrobial-resistant microorganisms, including multidrug-resistant types, are often responsible for healthcare-associated infections, but they are also responsible for infections in patients outside hospitals and can be found as part of the normal bacterial flora of healthy individuals, in pet animals and in the environment. 0.7301587301587301 Salmonella in Campylobacter, se širijo z uživanjem okužene hrane in lahko povzročajo drisko; Certain bacteria, e.g. Salmonella and Campylobacter are associated with consumption of contaminated foods and cause diarrhoea; 1.2857142857142858 Bolniki, ki so kolonizirani z odpornimi bakterijami oz. pri katerih so prisotne odporne bakterije, so na splošno izpostavljeni večjemu tveganju, da se bodo okužili s temi odpornimi bakterijami kot z občutljivimi različicami teh istih bakterij; Patients colonised by/carrying resistant bacteria are generally more likely to develop an infection with these resistant bacteria rather than with susceptible variants of the same bacteria; 1.054421768707483 Takšne bakterije so Enterobacteriaceae, ki izločajo karbapenemazo (KPC) (pogosto Klebsiella pneumoniae), in baterije Acinetobacter, odporne na več zdravil. Examples of such bacteria are carbapenemase (KPC)-producing Enterobacteriaceae (often Klebsiella pneumoniae), andmultidrug-resistant Acinetobacter. 1.2465753424657535 Uporaba protimikrobnih zdravil mikroorganizme prisili, da se prilagodijo, ali pa jih uniči. Any use of an antimicrobial forces microorganisms to either adapt or die. 1.0064516129032257 Enterobacteriaceae, ki izločajo beta laktamaze razširjenega spektra (ESBL) (med pogoste Enterobacteriaceae sodita Escherichia coli in Klebsiella pneumoniae) Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (examples of common Enterobacteriaceae are Escherichia coli and Klebsiella pneumoniae) 1.6181818181818182 Dva glavna dejavnika, ki prispevata k nastanku odpornosti na protimikrobna zdravila, sta: The two major drivers for antimicrobial resistance are: 0.528957528957529 čim bolj se antibiotiki uporabljajo v populaciji, tem večja je odpornost bakterij, ki povzročajo okužbe v tej populaciji, na antibiotike. Levels of antibiotic consumption consistently correlate with levels of antibiotic resistance, i.e. the more antibiotics are being used in a population, the more resistance to antibiotics there will be in bacteria responsible for infections in this population. 0.6092436974789915 V skladu z direktivo 2001/83/ES in nacionalnimi zakonodajami v državah članicah se smejo protimikrobna zdravila, ki se uporabljajo sistemsko (tj. Based on Directive 2001/83/EC and national legislations in Member States, antimicrobials to be used systemically (i.e. not locally) should only be dispensed at pharmacies upon presentation of a prescription, usually from a medical doctor. 0.989247311827957 Odpornost na več zdravil pomeni, da je mikroorganizem odporen na več protimikrobnih zdravil. Multidrug resistance corresponds to resistance of a microorganism to multiple antimicrobials. 1.2466666666666666 V primeru okužb s takšnimi bakterijami ustrezno zdravljenje z antibiotiki ni na voljo, zato se pri zdravljenju bolnikov pogosto uporabljajo stari in strupeni antibiotiki, kot je kolistin. There is no rational choice of antibiotic therapy for treating such patients and treatment often relies on old and toxic antibiotics such as colistin. 1.2530120481927711 zdravila proti zajedavcem (ki učinkujejo proti malariji in drugim okužbam, ki jih povzročajo zajedavci). Antiparasital drugs (active against malaria and other infections due to parasites). 1.0208333333333333 Tudi osebe, ki potujejo v državo z visoko odpornostjo na protimikrobna zdravila, vendar niso imele stika z zdravstveno oskrbo, so lahko ob vrnitvi kolonizirane z bakterijo, odporno na več zdravil. Even without having been in contact with healthcare, people who travel in a country with high prevalence of antimicrobial resistance may return being colonised by multidrug-resistant bacteria. 0.8253968253968254 protibakterijska zdravila, ki učinkujejo predvsem proti tuberkulozi in drugim mikobakterijskim okužbam), Antimycobacterial drugs (which are antibacterials specifically active against tuberculosis and other mycobacterial infections) 0.6131687242798354 Ta izraz ne vključuje le okužb, pridobljenih v bolnišnicah, temveč tudi okužbe, pridobljene na drugih mestih, kjer se izvaja zdravstvena oskrba, npr. The term "Healthcare-associated infections" is now preferred because it includes not only infections acquired in hospitals, but also in other settings where healthcare is provided, e.g. long-term care facilities, nursing homes, home care, etc. 1.0923913043478262 V nekaterih državah je opazno zmanjšanje uporabe antibiotikov pri ambulantnem zdravljenju kot tudi zmanjšanje odpornosti bakterij, ki pogosto povzročajo okužbe pri ambulantnih bolnikih, na antibiotike. In a few countries, decreasing trends are being observed for antibiotic use in outpatients and for antibiotic resistance in bacteria commonly responsible for infections in outpatients. 0.9312977099236641 le po potrebi, v pravilnem odmerku, v pravilnih intervalih odmerkov ter ob upoštevanju predpisanega trajanja zdravljenja); Prudent use of antimicrobials (i.e. only when needed, with the correct dose, at correct dose intervals and for a correct duration); 1.3404255319148937 protiglivična zdravila (ki učinkujejo proti glivičnim okužbam), Antifungals (active against fungal infections), 0.5213675213675214 Antibiotikov se ne sme uporabljati, kadar niso potrebni, npr. Antibiotics should not be used when they are not needed, e.g. for viral infections such as common colds or influenza; 0.78 na vankomicin odporni Enterococci (VRE) Methicillin-resistant Staphylococcus aureus (MRSA) 0.609375 Jemanje antibiotikov vedno spremeni normalno bakterijsko floro pri ljudeh, kar pogosto povzroči neželene učinke, npr. Taking antibiotics always modifies the human normal bacterial flora which often results in side effects, e.g. diarrhoea, as well as emergence and/or selection of antibiotic-resistant bacteria; 1.1538461538461537 Med pogoste bakterije, ki so odporne na več zdravil, sodijo: Examples of common multidrug-resistant bacteria are: 0.32941176470588235 gripi, virusu HIV, herpesu), Antivirals (active against viral infections, e.g. influenza, HIV, herpes infections), 0.6085526315789473 v pravilnem odmerku, v pravilnih intervalih ter ob upoštevanju predpisanega trajanja zdravljenja, da se optimira učinkovitost zdravljenja okužbe in čim bolj zmanjša nastanek odpornosti; When antibiotics are needed (this decision is made by a medical doctor who writes a prescription), they should then be used appropriately, i.e. at the correct dose, at correct intervals and for the prescribed duration, to optimise effectiveness to cure the infection and minimise emergence of resistance; 0.9139784946236559 To je primerljivo s skupnim številom potnikov na več kot 100 srednje velikih letalih. This is comparable to the total number of passengers of more than 100 medium-sized airplanes. 0.8376068376068376 Ko niso več učinkoviti, je izredno težko oziroma v številnih primerih nemogoče zdraviti te okužbe. When they are no longer effective, it is extremely difficult or, in many cases, impossible to treat these infections. 0.9732142857142857 To je povečanje od leta 2007 in je zaskrbljujoče, saj so ti antibiotiki zadnja obstoječa možnost zdravljenja. This is an increase from 2007 and is worrying because these antibiotics are the last treatment option available. 1.1481481481481481 Med letoma 2007 in 2015 se je povečalo breme vsake od 16 bakterij, odpornih proti antibiotikom, ki so bile zajete v študiji. Between 2007 and 2015, the burden of each of the 16 antibiotic-resistant bacteria under study has increased: 0.8757763975155279 To je zaskrbljujoče, saj se te bakterije zlahka širijo v zdravstvenem okolju, če ni ustreznih ukrepov za preprečevanje in obvladovanje okužb. This is a worrisome trend because these bacteria can spread easily in healthcare settings if adequate infection prevention and control measures are not in place. 1.075657894736842 Ključna sporočila temeljijo na članku, objavljenem 5. novembra 2018 v reviji The Lancet Infectious Diseases: Smrti in izgubljena leta življenja zaradi bolezni, invalidnosti ali prezgodnje smrti zaradi okužb z bakterijami, odpornimi na antibiotike, v EU in Evropskem gospodarskem prostoru leta 2015: analiza na ravni populacije. The key messages are based on an article published in The Lancet Infectious Diseases on 5 November 2018, Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis. 1.070921985815603 To bi bilo mogoče zmanjšati z ustreznimi ukrepi za preprečevanje in obvladovanje okužb, pa tudi z usmerjeno rabo antibiotikov v zdravstvenih ustanovah. This could be minimised through adequate infection prevention and control measures, as well as antibiotic stewardship in healthcare settings. 1.2167300380228137 Skupna izgubljena leta življenja zaradi bolezni, invalidnosti ali prezgodnje smrti po celotnem prebivalstvu ali breme bolezni se lahko razume kot meritev vrzeli med trenutnim zdravstvenim stanjem in idealnim zdravstvenim stanjem, v katerem bi celotno prebivalstvo živelo do visoke starosti, brez bolezni in invalidnosti. The sum of these DALYs across the population, or the burden of disease, can be thought of as a measurement of the gap between current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability. 1.0581717451523547 V članku je ocenjeno breme petih vrst okužb, ki jih povzročajo bakterije, odporne na antibiotike, (8 vrst bakterij, 16 kombinacij bakterij, odpornih na antibiotike) za javno zdravje v Evropski uniji in državah Evropskega gospodarskega prostora (EU/EGP) v letu 2015, ki se meri v številu primerov, smrti in izgubljenih let življenja zaradi bolezni, invalidnosti ali prezgodnje smrti. The article estimates the burden of five types of infections caused by antibiotic-resistant bacteria, (8 bacteria species, 16 antibiotic resistance-bacterium combinations) of public health concern in European Union and European Economic Area (EU/EEA) countries in 2015, measured in number of cases, attributable deaths and disabilityadjusted life years (DALYs). 0.9615384615384616 Zdravstveno breme zaradi odpornosti na antibiotike Key messages: Health burden of antibiotic resistance 1.0185185185185186 Breme okužb, ki jih povzročajo okužbe z bakterijami, odpornimi proti antibiotikom, je primerljivo s tistimi, ki jih povzročajo gripa, tuberkuloza in HIV/aids skupaj. The burden of infections with bacteria resistant to antibiotics on the European population is comparable to that of influenza, tuberculosis and HIV/AIDS combined. 1.1944444444444444 V Evropi je 75 % zdravstvenega bremena zaradi bakterij, odpornih na antibiotike, posledica okužb, povezanih z zdravstveno oskrbo. 75% of the burden of bacteria resistant to antibiotics in Europe is due to healthcare-associated infections. 0.9397590361445783 Okužbe z bakterijo E. coli, odporno na cefalosporin tretje generacije, so odgovorne za največje breme okužb, katerih več kot polovica se pojavi v ustanovah. Infections with third-generation cephalosporin-resistant E. coli are responsible for the highest burden and more than half of these infections occur in the community. 1.935483870967742 Izgubljeno leto življenja zaradi bolezni, invalidnosti ali prezgodnje smrti pomeni izgubljeno leto „zdravega" življenja. One DALY can be thought of as one lost year of "healthy" life. 1.3435114503816794 Število smrti, ki jih je mogoče pripisati okužbam z bakterijo Escherichia coli (v nadaljevanju E. coli), odporno na cefalosporin tretje generacije, se je povečalo za štirikrat. The number of deaths attributable to infections with third-generation cephalosporin-resistant Escherichia coli increased four-fold. 1.03 Zato je za zmanjšanje bremena teh okužb treba usmerjati predpisovanje antimikrobikov na ravni primarnega zdravstva, pa tudi sprejeti ukrepe za preprečevanje in nadzor okužb v primarnem zdravstvenem varstvu. Antimicrobial stewardship targeting primary care prescribers as well as infection prevention and control interventions in primary care are therefore necessary to reduce the burden of these infections. 0.9908256880733946 Vsako leto so okužbe z bakterijami, odpornimi proti antibiotikom, neposredno odgovorne za smrt 33 000 ljudi. Each year, 33000 people die as a direct consequence of an infection due to bacteria resistant to antibiotics. 1.044871794871795 Število smrti, ki jih je mogoče pripisati okužbam z bakterijo Klebsiella pneumoniae, ki je odporna proti karbapenemom, skupini antibiotikov zadnje obrambne linije, The number of deaths attributable to infections with Klebsiella pneumoniae resistant to carbapenems - a group of last-line antibiotics - increased six fold. 1.0161290322580645 Okužbe z bakterijami, odpornimi na antibiotike zadnje obrambne linije, kot so karbapenemi in kolistin povzročajo 39 % bremena. 39% of the burden is caused by infections with bacteria resistant to last-line antibiotics such as carbapenems and colistin. 1.3442622950819672 Na koncu vas prosimo, da kot vir tega grafičnega prikaza informacij navedete ECDC. Finally, please state ECDC as the source of this infographic. 0.7395833333333334 Odpornost proti antibiotikom - čedalje večja nevarnost za zdravje ljudi Antibiotic resistance - an increasing threat to human health - Design files - EN - [ZIP-3.71 MB] 0.975 • pretirano dolgo trajanje zdravljenja. excessively long durations of treatment. 1.0806451612903225 Ključne naloge za izboljšanje rabe antibiotikov v vaši ustanovi so: Core tasks to improve antibiotic use in your facility include: 1.1095890410958904 Izogibanje diagnostičnim testom in kulturam pri asimptomatskih bolnikih [56,111]. Avoiding diagnostic tests and cultures in asymptomatic patients [56,111]. 1.1538461538461537 • uporaba antibiotikov pri asimptomatskih bolnikih s pozitivnimi kulturami (kolonizacija); antibiotic use in asymptomatic patients with positive cultures (colonisation); 1.0462962962962963 Organizirajte izobraževalne dogodke in kampanje, ki prebivalcem nudijo informacije o preudarni rabi antibiotikov. Organise educational events and campaigns that provide residents with information on prudent antibiotic use. 1.1044776119402986 Ključna sporočila za ustanove za dolgotrajno oskrbo [zdravniki in vodstvo] Key messages for long-term care facilities - physician and managers 1.0405405405405406 Spodbujajte programe cepljenja za prebivalce in osebje [strokovno usklajeno]. Promote vaccination programmes for residents and staff [expert consensus]. 1.0 • topični antibiotiki in topical antibiotics; and 1.45 b) antibiotikov nikoli ne shranjujejo za poznejšo uporabo; b) Never save antibiotics for later use; 1.46 Izobraževanje zdravstvenega in negovalnega osebja, osredotočanje na področja, na katerih pogosto prihaja do zlorab antibiotikov, kot so [109,110]: Education of medical and nursing staff, targeting areas where antibiotic misuse is common [109,110]: 1.2378048780487805 Poskrbite, da bodo prebivalci (in njihovi družinski člani) razumeli razloge za zdravljenje z antibiotiki ter ključne točke v zvezi z rabo antibiotikov, pri čemer jih opozorite, naj [strokovno usklajeno]: Ensure that residents (and their families) understand the reasons for antibiotic therapy, and key points related to antibiotic use, including to [expert consensus]: 0.9893617021276596 Upoštevajte ukrepe za preprečevanje in obvladovanje okužb, ki so uveljavljeni v vašem okolju. Follow infection prevention and control measures that are already established in your setting. 1.3559322033898304 c) nikoli ne uporabljajo antibiotikov, ki so jim ostali od preteklih zdravljenj; c) Never use leftover antibiotics from previous treatments; 0.9803921568627451 V bolnikovi kartoteki dokumentirajte zdravljenje z antibiotiki, vrsto zdravila, odmerek, način dajanja zdravila in trajanje zdravljenja [31,42,70,71]. Document the indication of antibiotic treatment, drug choice, dose, route of administration and duration of treatment in the patient chart [31,42,70,71]. 1.008695652173913 Redno organizirajte preglede oziroma revizije/raziskave praks predpisovanja antibiotikov in bolnišničnih okužb [93]. Regularly organise audits/surveys of antibiotic prescribing practices and of healthcare-associated infections [93]. 1.2465753424657535 Zagotovite, da se pred zdravljenjem z antibiotiki odvzamejo ustrezne kužnine [31,42,70,71]. Ensure that cultures are taken before starting antibiotics [31,42,70,71]. 1.0476190476190477 a) antibiotike jemljejo v skladu z navodili; a) Take antibiotics exactly as prescribed; 1.1304347826086956 • antibiotična profilaksa; antibiotic prophylaxis; 0.8241758241758241 Preden predpišete antibiotik, vedno opravite klinični pregled bolnika [31]. Always perform a clinical examination of the patient before prescribing an antibiotic [31]. 0.7604166666666666 Ko predpisujete antibiotik, opravite temeljito anamnezo bolnika, vključno z nedavno rabo antibiotikov, alergijami na zdravila, uporabo imunosupresivnih zdravil in dejavniki tveganja za odpornost proti antibiotikom (npr. Take a thorough patient history when you prescribe an antibiotic, including recent antibiotic use, drug allergies, use of immunosuppressive therapy, and risk factors for antibiotic resistance (for example, recent hospitalisation, recent procedure or recent travel outside of Europe) [31]. 0.8493150684931506 d) antibiotikov, ki so jim ostali, nikoli ne delijo z drugimi. d) Never share leftover antibiotics with other residents or other people. 0.5 pljučnica, okužbe zgornjih dihalnih poti, okužbe kože in mehkih tkiv, okužbe sečil) in upoštevanje lokalnih podatkov o protimikrobni občutljivosti [109]; Using clinical pathways and evidence-based guidelines for diagnosing, treating and managing the most common infections (e.g. pneumonia, upper respiratory tract infections, skin and soft tissue infections, and urinary tract infections), and taking into account local antimicrobial susceptibility data [109]. 0.7592592592592593 Izobraževanje bolnikov in njihovih družinskih članov o tveganjih pojava bakterij, odpornih proti antibiotikom, če zdravljenje z antibiotiki je bilo nepotrebno (npr. Education of patients and their families on the risks of selecting for antibiotic-resistant bacteria when using antibiotics unnecessarily (e.g. asymptomatic bacteriuria, viral respiratory tract infections) [109,110]. 0.8863636363636364 Skupaj s strokovnjaki za preprečevanje in obvladovanje okužb izvajajte ukrepe za preprečevanje in obvladovanje okužb. Implement infection prevention and control measures together with infection prevention and control professionals [expert consensus]. 0.6 Izogibajte se nepotrebni antibiotični profilaksi (npr. Avoid unnecessary antibiotic prophylaxis (e.g. urinary tract infection prophylaxis) [111]. 1.5714285714285714 informativno gradivo, predstavitev, komplet informativnega gradiva Remove this filter Type: materiālu rīkkopa 1.0193548387096774 Povejte svetu, kako v svojem poklicnem ali zasebnem življenju, sami ali skupinsko, skrbite za odgovorno rabo antibiotikov in ohranjanje njihove učinkovitosti! Tell the world what you do, in your professional or personal life, at individual or collective level, to use antibiotics responsibly and keep them working! 1.4146341463414633 Odpornost proti antibiotikom - kakšne so trenutne razmere? Antibiotic resistance - where are we now? 0.9473684210526315 Če želite podpreti kampanjo, v tednu med 12. in 18. novembrom 2018 pod oznako #KeepAntibioticsWorking delite sporočila, slike ali videoposnetke. If you wish to support the campaign, share messages, pictures or videos during the week 18-24 November 2019, using the hashtag #KeepAntibioticsWorking . 0.9779411764705882 Pred odkritjem antibiotikov je na tisoče ljudi umiralo zaradi bakterijskih bolezni, kot sta pljučnica ali okužba po kirurškem posegu. Before the discovery of antibiotics, thousands of people died from bacterial diseases, such as pneumonia or infection following surgery. 1.180327868852459 Brez antibiotikov bi se lahko vrnili v „čas pred obstojem antibiotikov", kar pomeni, da presaditve organov, kemoterapija za zdravljenje raka, intenzivno zdravljenje in drugi medicinski postopki ne bi bili več mogoči. Without antibiotics, we could return to the "pre-antibiotic era", when organ transplants, cancer chemotherapy, intensive care and other medical procedures would no longer be possible. 1.1794871794871795 Bakterijske bolezni bi se širile in jih ne bi mogli več zdraviti, končale pa bi se s smrtjo. Bacterial diseases would spread and could no longer be treated, causing death. 0.9664429530201343 Le 70 let po uvedbi antibiotikov se srečujemo z možnostjo, da v prihodnosti ne bomo imeli učinkovitih zdravil za zdravljenje bakterijskih okužb. Only 70 years after the introduction of antibiotics, we are facing the possibility of a future without effective drugs to treat bacterial infections. 1.5357142857142858 Na evropski dan ozaveščanja o antibiotikih med drugim zdravnike, medicinske sestre, direktorje bolnišnic, farmacevte, kmete, veterinarje, oblikovalce politik, strokovne organizacije in organizacije bolnikov, vladne ustanove in splošno javnost prosimo, naj na Twitterju, Facebooku ali Instagramu objavijo svoje sporočilo in pojasnijo, kako skrbijo za ohranjanje učinkovitosti teh zdravil. Again this year, on the occasion of EAAD, we are asking doctors, nurses, hospital managers, pharmacists, farmers, veterinarians, policymakers, professional and patient organisations, governmental institutions, and the general public to share a message. 0.9741379310344828 Odpornost proti antibiotikom močno omejuje število antibiotikov, ki so na voljo za zdravljenje številnih bolezni. Antibiotic resistance severely limits the number of antibiotics available for the treatment of a number of diseases. 1.1867469879518073 Ker se odpornost proti antibiotikom povečuje in ker so v zadnjih letih odkrili in začeli tržiti le malo novih tovrstnih zdravil, je odpornost proti antibiotikom začela močno ogrožati javno zdravje. Because resistance is increasing and few new antibiotics have been discovered and marketed in recent years, antibiotic resistance is now a major public health threat. 0.8507462686567164 Od odkritja in začetka rabe antibiotikov je vse več bakterij, ki so bile sprva občutljive, postalo odpornih in je razvilo številne različne načine boja proti antibiotikom. Since antibiotics have been discovered and used, more and more bacteria, which were originally susceptible, have become resistant and developed numerous different means of fighting against antibiotics. 1.0804597701149425 Odpornost proti antibiotikom je sposobnost bakterij, da se borijo proti delovanju antibiotika. Antibiotic resistance is the ability of bacteria to resist the action of an antibiotic. 0.8392857142857143 Za učinkovitost antibiotikov smo odgovorni vsi! Everyone is responsible for keeping antibiotics working. 0.9262295081967213 15. novembra med 9.00 in 13.00 bomo na Twitterju v živo komentirali dogodek na ravni EU, ki bo potekal v Bruslju. On 18 November from 09.30 to 15.00 we will be tweeting live from our European Antibiotics Awareness Day 2019 Launch Event. 1.1538461538461537 Prenos lahko v živo spremljate na našem kanalu YouTube ali Facebook strani. Feel free to add them to your Twitter or Facebook profile photos! 1.451219512195122 Gibanju družbenih medijev ob evropskem dnevu ozaveščanja o antibiotikih v letu 2018 se lahko pridružite na več načinov. There are a number of ways for you to join the EAAD social media movement in 2019. 1.7586206896551724 Dogodek, ki ga bomo v živo komentirali na Twitterju Facebook Live & live tweeting 1.024390243902439 Ključna sporočila za klinične mikrobiologe Key messages for clinical microbiologists 1.2727272727272727 Ključna sporočila za zdravnike specializante in študente Key messages for junior doctors and students 1.0326086956521738 Splošna ključna sporočila za zdravstvene delavce v bolnišnicah in drugih zdravstvenih ustanovah General key messages for healthcare professionals in hospitals and other healthcare settings 1.1 Gradivo za zdravstvene delavce v bolnišnicah in drugih zdravstvenih ustanovah Materials for professionals in hospitals and other healthcare settings 0.9375 Ključna sporočila za urgentne oddelke [zdravniki in vodstvo] Key messages for emergency departments - physicians and managers 1.0 Paolo je 55-letni univerzitetni profesor v Rimu, v Italiji. Paolo is a 55 year old University Professor in Rome, Italy. 1.0 Zdravilo je jemal 21 dni. He took this for 21 days. 0.6521739130434783 Nihče ne ve, kje se je okužil. Nobody knows where he picked up the infection. 0.8409090909090909 Zato je nujno treba obiskati zdravnika in izvesti mikrobiološke preiskave. It is therefore necessary to see a doctor and to have microbiological testing performed. 0.89 Pomembno sporočilo za bolnike je, da je treba za zdravljenje predpisati pravi antibiotik. An important message for patients is that the right antibiotic needs to be prescribed for treatment. 1.0 Avgusta leta 2010 se je sam odpravil na izlet z motornim čolnom na Ponzo, otoček ob italijanski obali. In August of 2010, Paolo had gone motor-boating alone to Ponza, a small island off the coast of Italy. 1.0 Po tem obdobju so njegovi simptomi izginili in od tedaj je zdrav. His symptoms resolved after that and he has been well ever since. 0.7128712871287128 Posvetoval se je s svakom, ki je zdravnik in je bil na Ponzi na dopustu. He consulted with his brother-in-law, who is a medical doctor and was spending his holidays in Ponza. 1.056701030927835 Kljub temu je nadaljeval zdravljenje s ciprofloksacinom še teden dni ali dlje, saj je upal, da mu bo tako kmalu bolje in se bo lahko s čolnom vrnil v Rim ter šel na zdravstvene in laboratorijske preiskave. Despite this, he continued the course of ciprofloxacin for a week or more, with the hope of being well enough to motor-boat back to Rome and seek a full medical examination and laboratory tests. 0.9084967320261438 Zaskrbljujoče je, da se tako visoko odporne bakterije širijo v skupnosti in povzročajo okužbe pri ljudeh, ki niso imeli stika z bolnišnico. It is concerning that such highly resistant bacteria are spreading in the community and causing infections in patients with no contact with the hospital. 0.7534246575342466 Po prihodu na Ponzo je občutil simptome okužbe sečil, vendar jim ni posvečal velike pozornosti, saj je mislil, da gre za simptome dehidracije zaradi poletne vročine. After arrival in Ponza, he felt that he had symptoms of a urinary tract infection, but did not pay too much attention at the time, because he thought his symptoms could have been due to dehydration from the summer heat. 0.9064748201438849 Zavedal se je, da je pomembno poznati rezultate mikrobioloških preiskav urina, da lahko zdravnik predpiše ustrezen antibiotik. He was aware that it would be important to know the results of his urine culture in order for a doctor to prescribe the correct antibiotic. 0.9874213836477987 Pomembno je, da bolnika zdravimo s pravim antibiotikom, saj lahko te vrste visoko odpornih bakterij povzročijo poslabšanje bolezni in slabši izid za bolnika. It is important to treat with the right antibiotic, since these types of highly resistant bacteria can cause patients to be sicker and to have a worse outcome. 1.1686746987951808 Vendar pa se Paolovo stanje v naslednjih treh dneh ni izboljšalo in telesna temperatura ni padla. His condition did not improve over the next three days and his fever did not abate. 1.05 Zato se je bolnikovo stanje med zdravljenjem z amoksicilinom s klavulansko kislino navidezno izboljšalo, okužba pa ni bila odpravljena in se je po zaključenem zdravljenju nenadoma ponovila. This is why his condition apparently improved during amoxicillin-clavulanic acid treatment, but the infection was not eradicated and suddenly relapsed after the therapeutic course. 0.9801324503311258 Poklical je prijatelja, ki je specialist infektolog, in ta mu je predlagal, naj peroralno jemlje fosfomicin v odmerkih, ustreznih za njegovo okužbo. He then called a friend of his, an infectious disease specialist, who suggested that he take fosfomycin by mouth in the correct dose for his infection. 0.9294117647058824 Predpisali so mu amoksicilin s klavulansko kislino, ki ga je jemal štiri tedne. He was prescribed amoxicillin/clavulanic acid, which he took by mouth for four weeks. 0.75 Ob prihodu na celino je Paolo takoj obiskal veliko bolnišnico v Rimu, kjer so izvedli in klinični pregled, ki je potrdil zapleteno okužbo sečil. On arrival at the mainland, he immediately went to a large hospital in Rome where he had a urine culture and clinical examination, which confirmed he had a complicated urinary tract infection. 0.7142857142857143 Ugotovili so tudi povečano prostato, ki je bila verjeten vzrok okužbe. He was also found to have an enlarged prostate gland, which was the likely cause of his infection. 0.9137931034482759 Poleg karbapenemov, ki jih dajemo intravenozno in zahtevajo določeno obliko nastanitve v bolnišnici, je bolniku ostalo na voljo le še nekaj vrst antibiotikov, ki bi bli učinkoviti in bi jih lahko jemal peroralno. Aside from the carbapenems, which are given intravenously and require some type of hospital stay, there were only few antibiotics that he could take that would be effective against his infection, and few that he could take by mouth. 1.1549295774647887 Za ta antibiotik se lahko v laboratoriju bakterija izkaže občutljiva, dejansko pa pri zdravljenju proti E. coli, ki izloča ESBL, pri ljudeh antibiotik ni učinkovit. This antibiotic can appear sensitive in the laboratory, but is actually not effective against ESBL E. coli when given for treatment in humans. 0.9559748427672956 Njegovo stanje se je izboljšalo, a štiri dni po zaključku zdravljenja je telesna temperatura spet porasla in simptomi okužbe sečil so se znova pojavili. His condition improved, but four days after his treatment was discontinued, he began having fever again and his symptoms of a urinary tract infection returned. 1.1973684210526316 Poleg tega je bil na enega od teh antibiotikov, trimetoprim s sulfametoksazolom, alergičen. Additionally, he was allergic to one of them, trimethoprim-sulfamethoxazole. 0.972027972027972 V svetovnem merilu odkrivamo, da so bakterije, ki proizvajajo ESBL, vzrok okužb, pridobljenih v domačem okolju in pogosto prav okužb sečil. Globally, ESBL- producing bacteria are being found as the cause of community-acquired infections, and very frequently urinary tract infections. 0.8392857142857143 Predlagal mu je, naj vzame ciprofloksacin, fluorokinolonski antibiotik, ki je eden od najpogosteje uporabljenih antibiotikov za okužbe sečil. His brother-in-law suggested that he take ciprofloxacin, a fluoroquinolone antibiotic which is one of the most frequently used antibiotics for urinary tract infections. 1.0593220338983051 Ciprofloksacin je mogoče jemati peroralno, zato je enostaven za uporabo in je običajno učinkovit pri zdravljenju okužb sečil. Ciprofloxacin can be given by mouth, so is easy to take and is usually effective in treating urinary tract infections. 0.75 Šele po dveh mesecih zdravljenja s tremi različnimi antibiotiki je uspešno ozdravel. It took two months and three courses of different antibiotics before Paolo's infection was successfully treated. 1.0238095238095237 Na otočku Ponza Paolo ni imel možnosti za mikrobiološke laboratorijske preiskave urina, ki bi določile, s katerimi antibiotiki bi lahko zdravili njegovo bakterijsko okužbo. Paolo was on the island of Ponza where there was no possibility of laboratory testing of his urine to better understand which antibiotics the bug could be treated with. 1.0782122905027933 Gre za encime, zaradi katerih so bakterije, najpogosteje E. coli in Klebsiella pneumoniae, odporne proti večini betalaktamskih antibiotikov, vključno s penicilini, cefalosporini in aztreonamom. ESBLs are enzymes that make bacteria, most commonly E. coli and Klebsiella pneumoniae, resistant to most β-lactam antibiotics, including penicillins, cephalosporins and aztreonam. 1.0431654676258992 Karbapenemi, za katere je bila bakterija E. coli občutljiva, so antibiotiki prve izbire za bolnike z okužbami z bakterijami, ki proizvajajo ESBL. The carbapenems, to which his E.coli was sensitive, are the antibiotics of choice in patients with infections with ESBL-producing bacteria. 1.0938967136150235 Mikrobiološka preiskava urina je pokazala, da je bil okužen z bakterijo Escherichia coli (E. coli), ki je proizvajala laktamaze beta razširjenega spektra (ESBL) in je bila odporna na številne antibiotike, vključno s ciprofloksacinom. The culture showed that he was infected with a bacterium called Escherichia coli (E. coli), which produced an extended-spectrum beta-lactamase (ESBL) and was resistant to many antibiotics, including ciprofloxacin. 1.0610687022900764 Pomembne posebnosti tega primera so, da se je Paolova okužba razvila zaradi visoko odporne bakterije E. coli, pridobljene v domačem okolju. Important points to note in this case are that Paolo had developed an infection with a community-acquired highly resistant E. coli. 0.9173553719008265 Ker se ni upal sam vrniti s čolnom domov, saj bi se mu stanje med potjo lahko poslabšalo, ga je spremljal svak. Since he was afraid to motor-boat back to Rome by himself in case he became very ill, his brother-in-law accompanied him. 0.912 Čez čas se je pojavila še povišana telesna temperatura z mrzlico, simptomi okužbe sečil pa so postali izrazitejši. After a while, however, he developed a fever with shaking chills and the symptoms of his urinary tract infection intensified. 1.0612244897959184 Ugotovili so, da je Paolova bakterija E. coli občutljiva le za amoksicilin s klavulansko kislino, trimetoprim s sulfametoksazolom, fosfomicin in za karbapeneme, zadnjo obrambno vrsto antibiotikov, ki so zdravilo izbora za okužbe z bakterijami, ki tvorijo ESBL. Paolo's E. coli was found to be sensitive only to amoxicillin/clavulanic acid, trimethoprim-sulfamethoxazole, fosfomycin and to the carbapenems, a class of last-line antibiotics, which are the treatment of choice for bacteria that produce ESBLs. 0.8074534161490683 Odporna je bila proti fluorokinolonom, ki jih je mogoče jemati tudi peroralno za zdravljenje okužb sečil tudi za zapletene okužbe. coli was resistant to the fluoroquinolones, a class of antibiotics that can also be taken by mouth to treat urinary tract infections, including complicated ones. 1.0836820083682008 Laboratorijski rezultati so pokazali, da je bila bakterija, s katero je bil okužen Paolo, občutljiva le za amoksicilin s klavulansko kislino, trimetoprim s sulfametoksazolom, fosfomicin in še na antibiotike zadnje obrambne vrste, ki jih imenujemo karbapenemi. The laboratory results showed that the only antibiotics that Paolo's E. coli was sensitive to were amoxicillin/clavulanic acid, trimethoprim-sulfamethoxazole, fosfomycin and finally, a class of last line antibiotics called the carbapenems. 0.8410596026490066 Paolo je na dopustu zbolel za zapleteno okužbo sečil z bakterijo E. coli, ki izloča ESBL (laktamaze beta razširjenega spektra). While on holiday, Paolo developed a complicated urinary tract infection with an E. coli isolate that produced extended-spectrum-beta lactamases (ESBL). 0.8673469387755102 Paolo je na koncu prejel amoksicilin s klavulansko kislino, ki ga je jemal peroralno. The antibiotic that Paolo ended up taking was amoxicillin-clavulanic acid, which he took by mouth. 0.49760765550239233 Paolo peroralnega antibiotika trimetoprima ssulfametoksazolom ni smel jemati, saj je bil alergičen nanj. Paolo could not take trimethoprim-sulfamethoxazole, which is an oral antibacterial agent, because he was allergic to it. Carbapenems can only be given intravenously, meaning spending some time at the hospital. 0.9516129032258065 Uporaba antibiotikov se med državami EU/EGP zelo razlikuje. Antibiotic consumption varies widely between EU/EEA countries. 1.5918367346938775 grafični prikaz informacij informativno gradivo komplet informativnega gradiva infographic information material toolkit material 0.762589928057554 V državah z največjo uporabo ljudje zaužijejo 3,4-krat več antibiotikov kot v državah z najmanjšo uporabo. In the countries with the highest consumption, people consume 3.4 times more antibiotics than in the countries with the lowest consumption. 0.9297297297297298 Le 70 let od uvedbe antibiotikov se srečujemo z možnostjo, da v prihodnosti ne bomo imeli učinkovitih antibiotikov za zdravljenje bolnikov, okuženih z več vrstami bakterij. Only 70 years after the introduction of antibiotics, we are facing the possibility of a future without effective antibiotics for treating patients infected by several types of bacteria. 0.8828828828828829 Poleg tega grafični prikaz prikazuje deleže odpornosti proti najpogostejšim skupinam antibiotikov. Furthermore, the infographic shows the percentages of resistance against the most common groups of antibiotics. 0.995 Najnovejši podatki centra ECDC kažejo, da se je v bolnišničnem sektorju uporaba karbapenemov, ki spadajo v skupino rezervnih antibiotikov, v šestih državah zelo povečala, v nobeni pa se ni zmanjšala. In hospital sector, the latest ECDC data show that consumption of carbapenems - a last-line group of antibiotics - significantly increased in six countries and none of the countries showed a decrease. 0.8 V čem je težava? What is the problem? 0.8205128205128205 Portal ECDC (povezava) vsebuje spletne vire za pripravo smernic. The ECDC directory (link) contains online resources for developing guidelines. 1.5555555555555556 e) višjih neposrednih in posrednih stroškov bolnišničnega zdravljenja. e) Higher direct and indirect hospital costs. 0.9473684210526315 a) zavezanost vodstva (zagotavljanje razpoložljivosti potrebnih kadrovskih, tehnoloških in finančnih virov); a) Leadership commitment: ensuring the necessary resources in terms of staff, technology and budget are available. 0.8793103448275862 Odpornost se lahko prenese na druge bakterije [41]. This resistance may be transferred to other bacteria [41]. 1.0632911392405062 Te izboljšave niso povzročile nobenega povečanja neželenih posledic za bolnike [46]. These improvements did not cause any increase in adverse patient outcomes [46]. 0.8369565217391305 b) imenovanje vodij, ki so odgovorni za celoten program in rabo antibiotikov; b) Appointing leaders that are responsible for the overall programme and for antibiotic use. 1.0827067669172932 e) usposabljanje in izobraževanje za medicinsko, farmacevtsko, laboratorijsko, negovalno in drugo osebje, pa tudi za bolnike in njihove družine; e) Training and education for medical, pharmacy, laboratory, nursing, and non-clinical staff, as well as patients and their families; 0.9203539823008849 Antibiotiki imajo dolgotrajne učinke na razvoj in ohranjanje odpornosti proti antibiotikom v mikrobioti. Antibiotics have long-term effects on the development and persistence of antibiotic resistance in the microbiota. 1.0808080808080809 V skoraj polovici primerov je raba antibiotikov v evropskih bolnišnicah nepotrebna in neprimerna [6,37,38]. Up to a half of all antibiotic use in European hospitals is unnecessary or inappropriate [6,37,38]. 1.025 V evropskih bolnišnicah lahko okužbe z bakterijo Clostridium difficile povzročijo do 42 % večjo umrljivost, 19 dodatnih dni bolnišničnega bivanja in več kot 14 000 EUR dodatnih stroškov na bolnika [23,24]. In European hospitals, Clostridium difficile infections can lead to up to a 42% increase in mortality, 19 extra days of hospital stay, and more than EUR 14,000 of additional costs per patient [23,24]. 1.1037735849056605 d) preprečevanju in zmanjšanju odpornosti proti antibiotikom, skupaj z ukrepi za preprečevanje in obvladovanje okužb. d) Preventing and reducing antibiotic resistance, together with infection prevention and control measures. 1.0982142857142858 Izguba učinkovitih možnosti za zdravljenje in preprečevanje okužb predstavlja globalno grožnjo za zdravstveno varnost [31]. Losing effective options for the treatment and prevention of infections is a global health security threat [31]. 1.1497326203208555 a) zapoznelega dostopa posameznih bolnikov do učinkovitega zdravljenja z antibiotiki, kar povzroča neuspešno zdravljenje, daljše trajanje bolezni, podaljšano bivanje v bolnišnici ter povečano obolevnost in smrtnost; a) Delayed access to effective antibiotic therapy for individual patients, causing treatment failures, longer illnesses, prolonged stays in hospital and increased morbidity and mortality; 1.0258064516129033 e) izbira antibiotičnega zdravljenja se ponovno ne oceni po 48-72 urah oziroma se izbira antibiotika ne prilagodi glede na rezultate o mikrobioloških preiskav. e) Antibiotic therapy is not reviewed after 48-72 hours, or the choice of antibiotic is not streamlined when microbiological culture data become available. 1.0350877192982457 Kako naša uporaba antibiotikov prispeva k tej problematiki? How is our use of antibiotics contributing to the problem 1.1754385964912282 Zakaj bi morale bolnišnice spodbujati nadzor nad rabo antibiotikov? Why hospitals should be promoting antibiotic stewardship? 1.1484375 Okužbe z bakterijami, odpornimi proti več antibiotikom, so lahko hude, usodne in drage ter lahko vodijo neposredno do [2-11] [strokovno usklajeno]: Infections with multidrug-resistant bacteria can be severe, fatal and costly and can directly lead to [2-11] [expert consensus]: 1.143835616438356 c) skupine sodelavcev v bolnišnicah, ki vključujejo infektologe, klinične farmacevte in klinične mikrobiologe, za nudenje podpore zdravnikom, ki predpisujejo zdravila; c) Hospital-based teams, which include infectious disease specialists, clinical pharmacists and microbiologists, providing support to prescribers; 1.3263157894736841 Spodbujanje preudarne rabe antibiotikov je prednostna naloga tako z vidika varnosti bolnikov kot tudi javnega zdravja [31,42]. Promoting prudent antibiotic use is both a patient safety and a public health priority [31,42]. 1.0517241379310345 Antibiotike prejemajo številni bolniki v bolnišnicah [35,36]. Antibiotics are given to many hospital inpatients [35,36]. 1.2823529411764707 Program je zajemal ukrepe za nadzor nad rabo antibiotikov, ki so bili usmerjeni na uporabo karbapenemov [62]. The programme included antibiotic stewardship measures targeting carbapenem use [62]. 0.9343065693430657 Antibiotiki se bolnikom v bolnišnicah pogosto predpisujejo brez pojasnila o pomenu njihove preudarne rabe [strokovno usklajeno]. Antibiotics are often prescribed to patients in hospitals without explaining the importance of prudent antibiotic use [expert consensus]. 1.0377358490566038 b) več neželenih učinkov, saj je pogosto potrebno zdravljenje z nadomestnimi antibiotiki, ki so bolj toksični; b) More adverse events, because alternative antibiotic therapies, that are more toxic, must often be used; 0.8676470588235294 a) zapoznelo zdravljenje z antibiotiki pri kritično bolnih; a) Delayed administration of antibiotics in critically ill patients; 1.3174603174603174 Vse več evropskih držav je za zdravnike, ki predpisujejo zdravila v bolnišnicah, pripravilo nacionalne smernice o programih za nadzor nad rabo protimikrobnih zdravil. Increasingly, many European countries have national guidance on antimicrobial stewardship programmes for hospital prescribers. 1.2923076923076924 b) povečanju števila ozdravljenja okužb in zmanjšanju števila neuspešnih zdravljenj; b) Increasing infection cure rates and reduce treatment failures; 1.2015503875968991 Pobude za nadzor nad protimikrobnimi zdravili, ki spodbujajo preudarno rabo antibiotikov, se imenujejo programi za nadzor nad rabo antibiotikov [19,42-45]. Antimicrobial management initiatives that promote prudent antibiotic use are called antibiotic stewardship programmes [19,42-45]. 1.0526315789473684 Programi za nadzor nad rabo antibiotikov vključujejo večstranske ukrepe, kot so [19,42,43,44,48-57]: Antibiotic stewardship programmes consist of multifaceted actions, such as [19,42,43,44,48-57]: 1.1832669322709164 V združeni analizi programov za nadzor nad rabo antibiotikov se je njihova celotna raba zmanjšala (za 19 % po bolnišnicah in za 40 % na oddelkih za intenzivno zdravljenje), zmanjšali so se skupni stroški antibiotikov (za približno tretjino), skrajšalo se je tudi trajanje hospitalizacije (za 9 %). In a pooled analysis of antibiotic stewardship programmes, total consumption fell (by 19% hospital-wide and by 40% in intensive care units), overall antibiotic costs were reduced (by about one third), and the hospital length of stay shortened (by 9%). 0.8258426966292135 Razpoložljivost smernic, posvetovanje z infektologi in usposabljanja so najkoristnejši ukrepi za spodbujanje ustreznejše rabe antibiotikov [25,27]. Availability of guidelines, consultation with infectious diseases specialist, and trainings represent the most helpful interventions to promote better use of antibiotics [25,27]. 1.0818181818181818 d) slabše kakovosti bivanja bolnika v bolnišnici zaradi zaskrbljenosti ob uvedbi strogih ukrepov za obvladovanje okužb; d) Reduced quality of patient stay due to anxiety because of the need for rigorous infection control measures; 1.0555555555555556 • 80 % poročalo o zmanjšanju stroškov; • 80% reported reduced expenditures; 1.1956521739130435 Kako delujejo programi za nadzor nad rabo antibiotikov? How do antibiotic stewardship programmes work? 1.3035714285714286 Številni zdravniki, ki predpisujejo zdravila, ne poznajo, kako so razširjene odpornosti proti antibiotikom v njihovem lokalnem okolju, [25,26] in se zavedajo pomanjkanja usposabljanja na področju rabe antibiotikov [27]. Many prescribers do not know antibiotic resistance prevalence rates in their local setting [25,26], and recognise lacks in their training regarding antibiotic use [27]. 0.9603960396039604 Neustrezna raba antibiotikov pospešuje pojav in širjenje odpornosti proti antibiotikom [8,31-34]. Misuse of antibiotics accelerates the emergence and dissemination of antibiotic resistance [8,31-34]. 1.053191489361702 V nedavni raziskavi bolnišnic, ki so izvajale program za nadzor nad rabo antibiotikov, jih je [47]: In a recent survey of hospitals that had implemented an antibiotic stewardship programme [47]: 1.2283464566929134 Te bakterije, ki so odporne proti več antibiotikom, predstavljajo resnično in nenehno grožnjo za klinično prakso v vseh zdravstvenih ustanovah v Evropi [1]. Such multidrug-resistant bacteria are a real and constant threat to clinical practice in all healthcare settings in Europe [1]. 1.074766355140187 Pojav odpornosti proti antibiotikom ogroža zdravje in varnost bolnikov v vseh evropskih zdravstvenih ustanovah [1]. Antibiotic resistance threatens the health and safety of patients in all healthcare settings in Europe [1]. 1.2203389830508475 f) uporaba z dokazi podprtih smernic in politik glede rabe antibiotikov; f) Using evidence-based antibiotic guidelines and policies; 1.316326530612245 h) spremljanje odpornosti proti antibiotikom in njihove rabe ter posredovanje teh informacijzdravnikom, ki predpisujejo zdravila. h) Monitoring antibiotic resistance and use, and making this information available to prescribers. 1.1590909090909092 Razvoj in širjenje odpornosti proti antibiotikom sta verjetnejša v primeru [39] [strokovno usklajeno]: Antibiotic resistance is more likely to develop and spread when [39] [expert consensus]: 0.9183673469387755 Primeri strategij, ukrepov in rezultatov nadzora nad rabo antibiotikov v evropskih državah Examples of antibiotic stewardship strategies, actions and outcomes in European countries include: 1.1568627450980393 • 58 % poročalo o zmanjšanju odpornosti proti antibiotikom. • 58% reported reductions in antibiotic resistance. 1.3875 d) proaktivne revizije izdanih receptov za antibiotike s pošiljanjem povratnih informacij sodelavcem v skupini; d) Proactive auditing of antibiotic prescriptions with feedback to team members; 1.0568181818181819 Po Gramu negativne bakterije, kot so Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa in Acinetobacter spp., postajajo odporne proti večini razpoložljivih antibiotikov [16, 17]. Gram-negative bacteria, such as Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, and Acinetobacter spp., are becoming resistant to most available antibiotics [16,17]. 1.1339285714285714 c) manj učinkovitih antibiotikov za zdravljenje bolnikov z oslabljenim imunskim sistemom in tistih, ki so imeli kirurški poseg; c) Fewer effective antibiotic treatments for immunosuppressed patients and those undergoing surgical operations; 0.8624338624338624 Nizozemska - z uvedbo hitre obdelave mikrobioloških testov v učni bolnišnici se je povečal delež bolnikov, ki so prejeli ustrezno zdravljenje v prvih 48 urah [63]. Netherlands - Implementing rapid processing of microbiology tests increased the proportion of patients receiving appropriate treatment within the first 48 hours in a teaching hospital [63]. 1.1204819277108433 Programi za nadzor nad rabo antibiotikov lahko prispevajo k [42,45,46] [strokovno usklajeno]: Antibiotic stewardship programmes, can contribute to [42,45,46] [expert consensus]: 1.1481481481481481 Le nekaj antibiotikov, ki so trenutno v fazi raziskav in razvoja, bi lahko učinkovalo na obstoječe bakterije, ki so odporne proti več antibiotikom [28-30]. Only a few antibiotics in the research and development pipeline may be effective against existing multidrug-resistant bacteria [28-30]. 1.1566265060240963 Italija - z izvajanjem štiriletnega programa za obvladovanje okužb v učni bolnišnici se je zmanjšala incidenca okužb in kolonizacij, ki so jih povzročile bakterije, odporne proti karbapenemom. Italy - A four-year infection control programme decreased the incidence of infections and colonisation caused by carbapenem-resistant bacteria in a teaching hospital. 1.0443037974683544 Cefalosporini, karbapenemi, fluorokinoloni in protianaerobni antibiotiki predstavljajo visoko tveganje za pojav večkratno odpornih po Gramu negativnih bakterij [40]. Cephalosporins, carbapenems, fluoroquinolones and anti-anaerobe antibiotics have a high risk of selecting for multidrug-resistant Gram-negative bacteria [40]. 1.1764705882352942 c) zmanjšanju neželenih učinkov zaradi rabe antibiotikov ter c) Reducing adverse events from antibiotic use; and 1.1228070175438596 • 86 % poročalo o zmanjšanju rabe antibiotikov širokega spektra; • 86% reported reduced use of broad-spectrum antibiotics; 1.1297709923664123 Francija - z uporabo podpore informacijske tehnologije za predpisovanje antibiotikov se je v številnih bolnišnicah zmanjšala raba antibiotikov [59]. France - Using information technology support for antibiotic prescriptions decreased antibiotic consumption in many hospitals [59]. 1.010204081632653 Še posebej zaskrbljujoč je pojav bakterij, ki so odporne proti več različnim razredom antibiotikov. The emergence of bacteria resistant to multiple classes of antibiotics is particularly concerning. 1.2516556291390728 Švedska - revizije, ki so se izvajale dvakrat tedensko, in zagotavljanje povratnih informacij so na oddelku za interno medicino privedli do absolutnega 27 odstotnega zmanjšanja rabe antibiotikov, zlasti antibiotikov širokega spektra (cefalosporinov in fluorokinolonov), kot tudi do krajšega trajanja zdravljenja z antibiotiki in hitrejšega prehoda na peroralno zdravljenje [68]. Sweden - Twice weekly audit and feedback in an internal medicine department led to an absolute 27% reduction of antibiotic use , especially of broad-spectrum antibiotics (cephalosporins and fluoroquinolones), as well as shorter antibiotic treatment durations and earlier switching to oral therapy [68]. 0.9285714285714286 d) trajanje antibiotičnega zdravljenja je prekratko ali predolgo; d) The duration of antibiotic therapy is either too short or too long; 1.2533333333333334 S programi za nadzor nad rabo antibiotikov se lahko zmanjša stroške oskrbe bolnika [42,45,46]. Antibiotic stewardship programmes can reduce patient care costs [42,45,46]. 1.1505376344086022 Neustrezna raba antibiotikov povečuje tveganje okužbe z bakterijami, odpornimi proti več antibiotikom [15]. Misusing antibiotics increases the risk of infections with multidrug-resistant bacteria [15]. 1.2321428571428572 • 71 % poročalo o zmanjšanju števila okužb, povezanih z zdravljenjem; • 71% reported reduced healthcare-associated infections; 1.607843137254902 • 65 % poročalo o skrajšanju bolnišničnega bivanja oziroma zmanjšanju umrljivosti; • 65% reported reduced length of stay or mortality; 0.9438202247191011 Zloraba antibiotikov povečuje pojav okužb z bakterijo Clostridium difficile [19-22]. Misusing antibiotics increases the incidence of Clostridium difficile infections [19-22]. 1.0476190476190477 Španija - v učni terciarni bolnišnici je izobraževanje o smernicah skupaj z rednimi povratnimi informacijami v samo enem letu privedlo do 26 odstotnega povečanja števila ustreznih zdravljenj in 42 odstotnega zmanjšanja rabe antibiotikov [67]. Spain - After only one year, education on guidelines combined with regular feedback led to a 26% improvement in the rate of appropriate treatments, and a 42% reduction of antibiotic consumption at a tertiary teaching hospital [67]. 1.0254237288135593 Madžarska - posvetovanja z infektologi na oddelku za intenzivno zdravljenje so skupaj z omejevalno politiko predpisovanja antibiotikov privedla do manjše rabe vseh antibiotikov in izrazitega zmanjšanja rabe antibiotikov širokega spektra [61]. Hungary - Infectious disease specialist consultation in a surgical intensive care unit, together with a restricted prescribing policy, led to lower use of all antibiotics and a marked reduction in use of broad-spectrum antibiotics [61]. 1.1545064377682404 Nizozemska - z revizijo primerov za ponovno presojo o rabi antibiotikov po 48 urah se je na urološkem oddelku univerzitetne bolnišnice zmanjšala raba antibiotikov in skrajšalo trajanje hospitalizacije, ukrep pa je imel tudi neposreden pozitiven finančni učinek [64,65]. Netherlands - Case audits for the reassessment of antibiotic use after 48 hours reduced antibiotic consumption and length of stay in a urology ward of an academic hospital, and also had a positive direct return on investment [64,65]. 1.022875816993464 Na internih in kirurških oddelkih splošne bolnišnice za akutna stanja v Združenem kraljestvu se je incidenca okužb z bakterijo Clostridium difficile zmanjšala po uvedbi revizije smernic za empirično zdravljenje pogostih ih okužb z antibiotiki ter omejevalnih ukrepov za rabo florokinolonov in cefalosporinov [48]. The incidence of Clostridium difficile infections decreased in the medical and surgical wards of an acute general hospital in the United Kingdom in response to revised empirical antibiotic treatment guidelines for common infections and restrictive measures for fluoroquinolone and cephalosporin usage [48]. 1.0320284697508897 - Za bolnike z okužbami krvi so značilni trikrat večja umrljivost, daljša hospitalizacija in višji stroški, če so se okužili z bakterijo Escherichia coli, ki je odporna proti cefalosporinom tretje generacije, v primerjavi z izolati, ki so občutljivi za cefalosporine tretje generacije [12]. - Patients with bloodstream infections have a threefold higher mortality rate, prolonged hospital stays, and higher costs if their infection is due to third-generation cephalosporin-resistant Escherichia coli, compared with third-generation cephalosporin-susceptible isolates [12]. 1.0628272251308901 Poljska - s pripravo smernic za predpisovanje antibiotikov in dovoljenj za predhodno odobritev antibiotikov za omejeno rabo se je zmanjšala skupna raba antibiotikov na splošnem pediatričnem oddelku [66]. Poland - Developing guidelines for antibiotic prescriptions and pre-authorisation approval for restricted antibiotics decreased total antibiotic consumption in a general paediatric ward [66]. 1.1047120418848169 Francija - v učni bolnišnici z omejevanjem uporabe fluorokinolonov se je zmanjšala raba antibiotikov te vrste in zmanjšala stopnja prevalence bakterije Staphylococcus aureus, ki je odporna proti meticilinu [58]. France - Restricting use of fluoroquinolones reduced consumption of this class of antibiotics and decreased the rate of meticillin-resistant Staphylococcus aureus in a teaching hospital [58]. 1.1333333333333333 - Pri bolnikih je umrljivost trikrat večja, če je njihovo okužbo povzročila bakterija Klebsiella pneumoniae, ki je odporna proti karbapenemom, v primerjavi z izolati, ki so občutljivi za karbapeneme [14]. - Patients are up to three times more likely to die if their infections is caused by carbapenem-resistant Klebsiella pneumoniae, compared with carbapenem-susceptible isolates [14]. 0.9736842105263158 • rabe antibiotikov širokega spektra; • Broad-spectrum antibiotics are used; 1.2017543859649122 Nemčija - z uvedbo računalniškega podpornega sistema za sprejemanje odločitev je na petih oddelkih za intenzivno zdravljenje prišlo v petletnem obdobju do večjega upoštevanja lokalno prilagojenih smernic, večjega števila dni brez antibiotikov in zmanjšanja umrljivosti [60]. Germany - Implementing a computerised decision support system led to higher adherence to locally adapted guidelines, increased antibiotic-free days and reduced mortality over a five-year period in five intensive care units [60]. 0.6524822695035462 zahteve za pridobitev predhodnega dovoljenja in naknadno odobritev za določene antibiotike); g) Using restrictive measures for antibiotic prescriptions (e.g., pre-approval and post-authorization requirements for specific antibiotics); 0.8571428571428571 c) odmerek antibiotika je prenizek ali previsok; c) The dose of antibiotic is either too low or too high; 1.1694915254237288 • 96 % poročalo o zmanjšanju neprimernega predpisovanja antibiotikov; • 96% hospitals reported reduced inappropriate prescribing; 0.85 • prenizkih odmerkov antibiotikov. • Too low doses of antibiotics are used. 0.8611111111111112 b) spekter antibiotičnega zdravljenja je preozek ali preširok; b) The spectrum of antibiotic therapy is either too narrow or too broad; 0.3541666666666667 zdravljenje z antibiotiki ni klinično potrebno) ali neustrezno, npr. Antibiotics are misused when they are prescribed unnecessarily (i.e. antibiotic treatment is not clinically needed) or when they are prescribed inappropriately, i.e. one of the following [18]: 1.0338983050847457 - Pri bolnikih, okuženih z bakterijo Pseudomonas aeruginosa, odporno proti antibiotikom, je umrljivost večja za 24 % [13]. - Patients have a 24% increased risk of mortality with any antibiotic-resistant Pseudomonas aeruginosa infection [13]. 0.8974358974358975 EVROPSKA POBUDA NA PODROCJU ZDRAVJA European Antibiotic Awareness Day scarf 1.1666666666666667 Pogoji uporabe Terms of use 0.9696969696969697 ECDC želi slišati vaše predloge! ECDC would like to hear from you! 0.8205128205128205 Navodila za uporabo tega gradiva Instructions for use of these materials 0.8846153846153846 Center ECDC zanima, kako se komunikacijsko gradivo kampanje uporablja in kje, zlasti če menite, da bi vaše pobude lahko bile navedene na strani „Nacionalne dejavnosti" spletnega mesta. ECDC would be interested to know how and where the campaign communication materials are used, particularly if you think that your initiatives could be listed on the ‘National activities' page of this website. 0.9501466275659824 Dovoljenje za uporabo komunikacijskega gradiva kampanje Evropski dan ozaveščanja o antibiotikih imajo vse nepridobitne organizacije in zdravstvena združenja ter vsi evropski zdravstveni in vladni organi, ki izvajajo kampanje, namenjene zmanjševanju odpornosti proti antibiotikom, in spodbujajo ustrezno uporabo antibiotikov. Permission to use the European Antibiotic Awareness Day campaign communication materials is granted to all non-profit organizations and healthcare associations as well as all European healthcare authorities and governmental bodies conducting campaigns aimed at reducing antibiotic resistance and promoting the appropriate use of antibiotics. 0.9642857142857143 Če imate kakršna koli vprašanja glede gradiva, nam pišite na: EAAD@ecdc.europa.eu For any questions you may have on the materials, please contact: EAAD@ecdc.europa.eu 0.925 Podrobnejše informacije in zamisli o tem, kako uporabljati to gradivo in organizirati kampanjo o samozdravljenju z antibiotiki, najdete v navodilih. For further detailed information and ideas how to use these materials and organise a campaign on self-medication with antibiotics, please see the Guidance note. 1.9928057553956835 Vsi drugi subjekti morajo pred uporabo komunikacijskega gradiva kampanje Evropski dan ozaveščanja o antibiotikih pridobiti soglasje Evropskega centra za preprečevanje in obvladovanje bolezni (ECDC).Za pridobitev dovoljenja za uporabo tega gradiva pišite na: EAAD@ecdc.europa.eu Any other entities must obtain the consent of the ECDC before using the European Antibiotic Awareness Day campaign communication materials. 1.9090909090909092 Sporočilo, namenjeno zdravstvenim delavcem See the survey results 1.027027027027027 Pripravite smernice za zbiranje, shranjevanje in prenašanje vzorcev [98,99]. Provide guidelines for specimen collection, storage and transport [98,99]. 1.186046511627907 Vaše naloge v zvezi z izboljšanjem uporabe antibiotikov vključujejo [31,98-100] [strokovno usklajeno]: Your tasks related to improving antibiotic use include [31,98-100] [expert consensus]: 0.8807339449541285 g) zagotavljanje smernic za primerno zbiranje vzorcev, uveljavljanje meril za zavrnitev vzorcev, ki niso bili primerno odvzeti, in vzpostavljanje postopkov, ki preprečujejo kontaminacijo (npr. g) Providing guidelines for appropriate specimen collection, enforcing rejection criteria for specimens submitted inappropriately, and establishing procedures to limit the work-up of contaminants (e.g. blood cultures); 1.1262626262626263 Zagotovite, da se pri laboratorijskem testiranju in poročanju o protimikrobni občutljivosti upoštevajo terapevtske smernice (vključno s selektivnim poročanjem) ter da po potrebi vključujejo ustrezne pripombe k razlagi [31]. Ensure that laboratory testing and antimicrobial susceptibility reporting follow treatment guidelines (including selective reporting), and include relevant comments on interpretation if needed [31]. 0.8432835820895522 b) sodelovanje z infektologom in bolnišničnim farmacevtom pri izvajanju programa za nadzor nad rabo antibiotikov; b) Collaborating with the infectious disease specialist and the hospital pharmacist to implement the antibiotic stewardship programme; 1.2936507936507937 Redno izobražujte vse zdravnike, ki predpisujejo zdravila, o odpornosti proti antibiotikom ter o uporabi hitrega diagnostičnega testiranja na mestu oskrbe [31,53]. Train hospital prescribers regularly on antibiotic resistance, and on use of rapid and point-of-care diagnostic tests [31,53]. 0.8985507246376812 e) takojšnje poročanje o kritičnih izvidih lečečemu zdravniku; e) Communicating critical results promptly to the treating physician; 0.9615384615384616 Podatke o odpornosti proti antibiotikom v bolnišnici in po oddelkih poročajte skupini za nadzor nad rabo antibiotikov ter skupini za preprečevanje in obvladovanje okužb [101]. Provide data on antibiotic resistance at hospital level and ward level, and communicate trends to the antibiotic stewardship team and the infection prevention and control team [101]. 1.009009009009009 c) podpiranje z dokazi podprtih bolnišničnih smernic o antibiotikih pri pogostih okužbah in kirurški profilaksi; c) Supporting evidence-based hospital antibiotic guidelines for common infections and for surgical prophylaxis; 1.0786516853932584 i) prepoznavanje pomembnih pojavov glede odpornosti proti antibiotikom v bolnišnici in takojšnje posredovanje opažanj skupini za nadzor nad rabo antibiotikov ter skupini za obvladovanje okužb; i) Identifying critical trends in antibiotic resistance in the hospital and promptly communicating observations to the antibiotic stewardship team and the infection control team. 1.0451977401129944 Evropskega odbora za testiranje protimikrobne občutljivosti - EUCAST) in nacionalni standardi (Slovenske komisije za ugotavljanje občutljivosti za protimikrobna zdravila - SKUOPZ) [31]. Ensure that testing and reporting of microbiology results follow European and national standards (i.e. European Committee on Antimicrobial Susceptibility Testing - EUCAST) [31]. 0.9318181818181818 h) vodenje empiričnega antibiotičnega zdravljenja z zagotavljanjem zbirnih podatkov testiranja protimikrobne občutljivosti za bolnišnico ali posamezne oddelke (npr. h) Guiding empirical antibiotic therapy by providing hospital and ward specific (e.g. intensive care unit or emergency department) cumulative antimicrobial susceptibility data; 0.5203252032520326 d) pravočasno prepoznavanje in poročanje o mikroorganizmih (npr. d) Timely identification and reporting of microorganisms (e.g. in blood cultures) and antimicrobial susceptibility testing; 1.1488372093023256 Zagotovite, da se rezultati testiranj v zvezi s prepoznavanjem in protimikrobno občutljivostjo posredujejo zdravnikom, ki predpisujejo zdravila, negovalnemu osebju in skupini za nadzor na rabo antibiotikov, zlasti v primeru kritičnih izvidov (npr. Ensure that identification and antimicrobial susceptibility testing results are communicated to prescribers, nurses and the antibiotic stewardship team especially for critical results (e.g. blood cultures) [98-100]. 0.62 j) vodenje bolnišničnih katalogov protimikrobnih zdravil (npr. j) Managing your hospital's antimicrobial formulary (i.e., list of drugs available for prescribers). 0.46551724137931033 f) predstavljanje podatkov na način, ki podpira preudarno rabo antibiotikov, npr. f) Presenting data in a way that supports prudent antibiotic use, for example by selectively reporting to physicians a limited number of antimicrobial susceptibility results; 0.45517241379310347 Glavna ciljna javnost so predpisovalci antibiotikov v bolnišnicah. The proposed activities are presented in three sections that are targeting the general public, primary care prescribers and hospital prescribers. 1.7142857142857142 slika komplet informativnega gradiva communication toolkit 0.6689655172413793 Fotografija za ponazoritev preudarne uporabe antibiotikov v bolnišnicah, ki jo je mogoče prenesti The research showed that there is already some social media activity on prudent antibiotic use and that a few potential influencers are emerging. 0.5068027210884354 Sekundarna javnost so direktorji bolnišnic in deloma tudi farmacevti v bolnišnicah ter farmacevtski odbori/odbori za usmerjanje uporabe antibiotikov. This guidance document is based on research of social media activity related to antibiotic use at EU level, as well as on a survey of the social media activities of EAAD partner organisations, mostly EU umbrella organisations of patients and health professionals (see Appendix 2 for full list). 1.0684931506849316 d) izobraževanje osebja o nalezljivih boleznih in preudarni rabi antibiotikov. d) Educating staff on infectious diseases and prudent use of antibiotics. 1.0476190476190477 Klinične naloge v zvezi z izboljšanjem rabe antibiotikov so [102] [strokovno usklajeno]: Clinical tasks related to improving antibiotic use include [102] [expert consensus]: 1.0571428571428572 e) obveščanje bolnikov (in njihovih družinskih članov) o indikaciji za zdravljenje z antibiotiki, možnih neželenih učinkih in njihovi pravilni rabi. e) Informing patients (and their families) about the indication for an antibiotic prescription, possible side effects, and their proper use. 1.0380952380952382 To bi moralo vključevati indikacijo, izbiro zdravil, odmerek, način dajanja zdravila in trajanje zdravljenja; This should include the indication, drug choice, dose, route of administration and duration of treatment. 1.2637362637362637 c) izboljšanje nadaljnjega spremljanja v realnem času in interpretacije rezultatov mikrobioloških kultur v sodelovanju z mikrobiološkim laboratorijem za učinkovito posredovanje rezultatov vsem zdravnikom, ki predpisujejo zdravila; c) Strengthening real-time follow-up and interpretation of microbiological culture data, by coordinating with the microbiology laboratory to efficiently share results to prescribers. 1.1692307692307693 b) zagotavljanje, da smernice vključujejo lokalne mikrobiološke in antibiotične vzorce odpornosti ter da odražajo obstoječi bolnišnični katalog zdravil; b) Ensuring guidelines incorporate local microbiology and antibiotic resistance patterns, and reflect existing hospital formulary. 0.839622641509434 Pri bolnikih s hudo okužbo čim prej začnite učinkovito zdravljenje z antibiotiki [31,74]. For patients with a severe infection, initiate effective antibiotic treatment as soon as possible [31,74]. 1.2142857142857142 b) odločanje o prvem odmerku antibiotika za hospitalizirane bolnike; b) Deciding on the first antibiotic dose for inpatients; 1.0333333333333334 c) odvzem ustreznih kužnin pred začetkom zdravljenja z antibiotiki, kar omogoča, da se zdravljenje z antibiotiki med hospitalizacijo prilagodi ali preneha; c) Taking relevant cultures, before starting antibiotic therapy, which will allow antibiotic therapy to be tailored or stopped during hospitalisation; 0.9558823529411765 Režim jemanja antibiotikov, ki se začne na vašem oddelku, močno vpliva na nadaljevanje zdravljenja v bolnišnici in skupnosti [77]. Antibiotic regimens started in your department strongly influence what therapy is continued in the hospital and community settings [77]. 0.9565217391304348 Ste na pomembnem položaju, ki vam omogoča da izboljšate predpisovanje antibiotikov za bolnike v bolnišnici in zunaj nje, saj vaša ustanova povezuje bolnišnico in skupnost [77]. You are in an important position to improve antibiotic prescribing in both inpatients and outpatients, since your facility sits at the interface of the hospital and the community [77]. 0.9831932773109243 Seznanite se z odpornostjo proti antibiotikom v svoji skupnosti, bolnišnici in na oddelku [31] [strokovno usklajeno]. Remain aware of local antibiotic resistance patterns in the community, hospital and department [31] [expert consensus]. 0.6666666666666666 za sepso [74], okužbe sečil [103], okužbe kože in mehkih tkiv [104]) ter izvajajte ukrepe preprečevanja in obvladovanja okužb, ki so uveljavljene v vašem okolju [31] [strokovno usklajeno]. Follow antibiotic treatment protocols, based on evidence-based guidelines (e.g. for sepsis [74], urinary tract infections [103], skin and soft tissue infections [104]), and apply infection prevention and control measures that are established in your setting [31] [expert consensus]. 1.3277310924369747 d) sporočanje vseh ustreznih informacij o anamnezi bolnika in odločitvah v zvezi z zdravljenjem zdravnikom v bolnišnici in zunaj nje, ki bodo prevzeli primer; d) Communicating all relevant patient background and treatment decisions to in- or out-patient follow-up practitioners. 1.1794871794871795 a) upoštevanje lokalnih, z dokazi podprtih smernic o rabi antibiotikov pri pogostih okužbah; a) Following local evidence-based antibiotic guidelines for common infections; 0.7517241379310344 a) dajanje na voljo razpoložljivih, z dokazi podprtih smernic o rabi antibiotikov ter kliničnih poti za diagnosticiranje, zdravljenje in obvladovanje najpogostejših okužb, s katerimi se srečujete na vašem oddelku (npr. a) Making available evidence-based hospital antibiotic guidelines and clinical pathways for diagnosing, treating and managing the most common infections encountered in your department (i.e. respiratory tract infections, skin and soft tissue infections, urinary tract infections and sepsis). 1.0975609756097562 komplet informativnega gradiva, videoposnetek Remove this filter Type: toolkit material 1.1290322580645162 EVROPSKA POBUDA NA PODROCJU ZDRAVJA healthcare workers in hospitals 0.39464882943143814 Bakterije, odporne proti antibiotikom, pomenijo nevarnost za vse nas, ker povzročajo okužbe, ki jih je težko zdraviti. Antibiotic stewardship programmes, together with infection prevention and control practices, can increase patient safety and quality of care and reduce hospital costs across all services by improving how antibiotics are used, as well as by decreasing C. difficile infections and other adverse events 0.7272727272727273 Povzetek dejstev za strokovnjake Key messages for junior doctors and students 1.1797752808988764 Šestina Evropejcev se ne zaveda, da napačna uporaba antibiotikov zmanjša njihovo učinkovitost (podnapisi) Up to a half of all antibiotic use in European hospitals is unnecessary or inappropriate. 1.3404255319148937 Kaj počne center ECDC za ohranjanje učinkovitosti antibiotikov? What is ECDC doing to keep antibiotics working? 1.6545454545454545 Evropski dan ozaveščanja o antibiotikih po vsej Evropi vsako leto obeležujemo 18. novembra. Each year across Europe, EAAD is marked on 18 November. 1.1176470588235294 Center ECDC se tudi partnersko povezuje s številnimi strokovnimi organizacijami in organizacijami bolnikov, Evropsko komisijo, Evropsko agencijo za varnost hrane, Evropsko agencijo za zdravila in regionalnim uradom Svetovne zdravstvene organizacije za Evropo ter mednarodnimi kampanjami v Združenih državah Amerike, Avstraliji, na Novi Zelandiji, v Kanadi in na Japonskem ter s številnimi ukrepi obravnava odpornost proti antimikrobikom. ECDC also partners with numerous professional and patient organisations, the European Commission, the European Food Safety Authority, the European Medicines Agency and the World Health Organization Regional Office for Europe, as well international campaigns in the United States, Australia, New Zealand, Canada and Japan, to undertake a number of actions to address antimicrobial resistance. 1.2148148148148148 Dejavnosti, povezane s to temo v centru ECDC, potekajo v okviru programa za preprečevanje odpornosti proti antimikrobikom in okužb, povezanih z zdravstveno oskrbo . Activities related to this topic at ECDC take place under the Antimicrobial Resistance and Healthcare-associated Infections programme . 1.0872093023255813 Med glavnimi področji dela centra ECDC so nadzor, epidemiološko obveščanje, oblikovanje smernic, podprtih z dokazi, in sistematičnih pregledov, usposabljanje, podpora državam članicam EU. ECDC's main areas of work include surveillance, epidemic intelligence, developing evidence-based guidance and systematic reviews, training, support to the EU Member States. 1.116751269035533 Center ECDC od leta 2008 usklajuje evropski dan ozaveščanja o antibiotikih, evropsko pobudo za javno zdravje, katere namen je zagotoviti ustrezno platformo in podpirati nacionalne kampanje za preudarno rabo antibiotikov. Since 2008, ECDC coordinates the European Antibiotic Awareness Day, a public health initiative which aims to provide a platform and support for national campaigns on the prudent use of antibiotics. 1.0708333333333333 Center ECDC je tudi vzpostavil in redno posodablja imenik spletnih virov za preprečevanje in obvladovanje odpornosti proti antimikrobikom in okužb, povezanih z zdravstveno oskrbo, s čimer podpira države članice EU, ki morajo oblikovati nacionalne smernice . ECDC also launched, and regularly updates, a directory of online resources for the prevention and control of antimicrobial resistance and healthcare-associated infections to support EU Member States that need to develop national guidelines. 1.0089820359281436 Evropski center za preprečevanje in obvladovanje bolezni (ECDC) k ohranjanju učinkovitosti antibiotikov prispeva tako, da z letnim posodabljanjem evropskih nadzornih podatkov skrbi, da imamo v Evropi dober pregled nad stanjem odpornosti proti antibiotikom in njihovo porabo, ter aktivno spodbuja in zagovarja preudarno rabo antibiotikov. The European Centre for Disease Prevention and Control (ECDC) contributes to keep antibiotics working by ensuring that Europe has a good overview of the situation on antibiotic resistance and antibiotic consumption with a yearly update of its European surveillance data, and actively promotes and advocates prudent use of antibiotics. 2.5161290322580645 grafični prikaz informacij informativno gradivo komplet informativnega gradiva Twitter Facebook Linked In Mail 0.972972972972973 slika komplet informativnega gradiva information material toolkit material 1.088235294117647 Komplet informativnega gradiva za predpisovanje antibiotikov v bolnišnicah Checklist for prescribers in hospitals and other healthcare settings 1.0276073619631902 Komplet informativnega gradiva vsebuje predloge dokumentov in nekaj predlaganih ključnih sporočil, ki se osredotočajo na samozdravljenje z antibiotiki, zamisli za dejavnosti ozaveščanja in predlagane pristope za seznanjanje širše javnosti s preudarno uporabo antibiotikov, zlasti tistih oseb, ki antibiotike uporabljajo na lastno pest. The toolkit contains template materials and some suggested key messages focusing on self-medication with antibiotics, ideas for awareness raising activities, and suggested tactics for getting the messages across to the general public regarding prudent use of antibiotics, especially to people self-medicating with antibiotics. 0.8980891719745223 Obvladovanje teh tveganj in tudi dejavnikov, ki prispevajo k obvladovanja nalezljivih bolezni, je v pristojnosti posamezne države članice EU. Management of these risks as well as of the factors that contribute to control of communicable diseases are under the responsibility of each EU Member State. 1.161764705882353 Dejavnosti, povezane s to temo v centru ECDC, potekajo v okviru programa za preprečevanje odpornosti proti mikrobom in okužb, povezanih z zdravstveno oskrbo . Activities related to this topic at ECDC, take place under the Antimicrobial Resistance and Healthcare-associated Infections programme . 1.0029154518950438 Od leta 2008 so številne zdravstvene in strokovne organizacije ter Evropska komisija in Regionalni urad Svetovne zdravstvene organizacije (SZO) za Evropo kot partnerji sodelovali s centrom ECDC pri pripravi komunikacijskih gradiv in načrtovanju dejavnosti, namenjenih ciljnim skupinam, kot so splošna javnost in strokovni delavci v bolnišnicah. Since 2008, numerous health-related and professional organisations, as well as the European Commission and the World Health Organization Regional Office for Europe (WHO/Europe), have partnered with ECDC in preparing communications materials and planning activities targeting audiences such as the general public and professionals in hospitals. 1.0813953488372092 Med glavnimi področji dela centra ECDC so nadzor, epidemiološko obveščanje, razvijanje smernic, podprtih z dokazi, in sistematičnih pregledov, usposabljanje, podpora državam članicam EU. ECDC's main areas of work include surveillance, epidemic intelligence, developing evidence-based guidance and systematic reviews, training, support to the EU Member States. 1.0666666666666667 Nazadnje, center ECDC vsako leto 18. novembra usklajuje evropski dan ozaveščanja o antibiotikih. Finally, on 18 November each year, ECDC coordinates the European Antibiotic Awareness Day. 0.9836065573770492 Center ECDC je pristojen za opredelitev in oceno tveganj nalezljivih bolezni za državljane EU ter obveščanje o teh tveganjih, kar vključuje tudi področje odpornosti proti mikrobom. The mandate of ECDC is to identify and assess the risks of communicable diseases for EU citizens and communicate about these risks; this includes the area of antimicrobial resistance. 1.0416666666666667 Center ECDC je tudi vzpostavil in redno posodablja imenik spletnih virov za preprečevanje in obvladovanje odpornosti proti mikrobom in okužb, povezanih z zdravstveno oskrbo, s čimer podpira države članice EU, ki morajo oblikovati nacionalne smernice. ECDC also launched, and regularly updates, a directory of online resources for the prevention and control of antimicrobial resistance and healthcare-associated infections to support EU Member States that need to develop national guidelines. 1.1788617886178863 Poleg tega je od navedenega leta več kot 43 držav v evropski regiji pripravilo kampanje pod okriljem evropskega dneva ozaveščanja o antibiotikih. In addition, more than 43 countries in the European region have had campaigns since that year, all under the EAAD umbrella. 1.013215859030837 Evropski center za preprečevanje in obvladovanje bolezni (ECDC) je leta 2008 odločil, da bo 18. november evropski dan ozaveščanja o antibiotikih, in tako zagotovil platformo za zagotavljanje podpore nacionalnim kampanjam v regiji. The European Centre for Disease Prevention and Control (ECDC) decided in 2008 to establish the European Antibiotic Awareness Day (EAAD) on 18 November as a platform for providing support to national campaigns across the region. 0.541958041958042 EU je novembra 2001 sprejela Priporočilo Sveta o preudarni rabi protimikrobnih sredstev v humani medicini, v katerem je bilo navedeno, da morajo države članice EU obvestiti splošno javnost o pomenu preudarne uporabe protimikrobnih sredstev, predstavljen pa je bil tudi uspeh nekaterih nacionalnih kampanj, npr. Following adoption of the European Union (EU) Council Recommendation on the prudent use of antimicrobial agents in human medicine in November 2001, which stated that EU Member States should inform the general public of the importance of prudent use of antimicrobial agents and the success of some national campaigns, such as Belgium and France, the European Centre for Disease Prevention and Control (ECDC) decided in 2008 to establish the European Antibiotic Awareness Day (EAAD) on 18 November as a platform for providing support to national campaigns across the region. 0.668918918918919 Svetovna zdravstvena organizacija od leta 2015 vodi svetovni teden ozaveščanja o antibiotikih , tj. Since 2015, the World Health Organization leads the World Antibiotic Awareness Week , a global campaign taking place on the week of the 18 November. 2.16 Evropski dan ozaveščanja o antibiotikih kot partner sodeluje pri svetovnem tednu ozaveščanja o antibiotikih. EAAD partners with World Antibiotic Awareness Week 0.8067226890756303 Ta sporočila upoštevajte poleg tistih za posebne ciljne skupine za vaše področje specializacije. Consider these messages in addition to those for the specific target groups that relate to your area of specialisation. 1.034934497816594 c) Ali ste preverili nedavno rabo antibiotikov, alergije na zdravila, uporabo imunosupresivnih zdravil, nedavno hospitalizacijo ali institucionalizacijo, nedavno potovanje zunaj Evrope in mikrobiološke rezultate v preteklih treh mesecih? c) Have you checked for recent antibiotic use, drug allergies, use of immunosuppressive therapy, recent hospitalisation or institutionalisation, recent travel outside of Europe, and microbiology results for the previous 3 months? 0.9029126213592233 a) Ali obstaja večja verjetnost za bakterijsko okužbo kot za kolonizacijo ali virusno okužbo? a) Is there a high probability of a bacterial infection, rather than colonisation or a viral infection? 1.0510204081632653 • za smernice in nasvet prosite starejšega sodelavca ali člana skupine za nadzor nad rabo antibiotikov; • Seek guidance and advice from a senior colleague or a member of the antibiotic stewardship team; 0.8169014084507042 d) Ali ima bolnik okužbo, ki se bo odzvala na antibiotike? d) Does the patient have an infection that will respond to antibiotics? 1.3098591549295775 Če imate pomisleke, se posvetujte s skupino za nadzor nad rabo antibiotikov [31,42,53,70,71]: If in doubt, consult with antibiotic stewardship team [31,42,53,70,71]: 1.1666666666666667 Izobražujte se in upoštevajte vsa priporočila v zvezi z nadzorom nad rabo antibiotikov ter preprečevanjem okužb, ki so pomembna za vaše področje specializacije [strokovno usklajeno]. Learn and apply all antibiotic use and infection prevention and control recommendations that are relevant to your area of specialisation [expert consensus]. 1.1941176470588235 Poskrbite, da bodo bolniki (in njihovi družinski člani) razumeli razloge za zdravljenje z antibiotiki ter ključne točke v zvezi z njihovo rabo, pri čemer jih opozorite, naj [31,69] [strokovno usklajeno]: Ensure that patients (and their families) understand the reason for antibiotic therapy, and key points related to antibiotic use, including to [31,69] [expert consensus]: 1.0126582278481013 b) Ali so bile pred začetkom zdravljenja z antibiotiki odvzete ustrezne kužnine? b) Have the appropriate cultures been taken before starting antibiotic therapy? 1.05 Preden predpišete antibiotik, storite naslednje [25,26,53,70] [strokovno usklajeno]: Before you prescribe an antibiotic, you should [25,26,53,70] [expert consensus]: 1.378787878787879 Za čim bolj kakovostno zdravljenje z antibiotiki odgovorite na naslednja ključna vprašanja. Answer the following key questions to optimise antibiotic therapy. 1.2195121951219512 Ko opazite, da je bil predpisan antibiotik, zdravnika, ki ga je predpisal, povprašajte o indikaciji, izbiri, odmerku, načinu dajanja zdravila in trajanju zdravljenja, da bi ugotovili, ali so bile upoštevane smernice o predpisovanju antibiotikov [69]. When you see an antibiotic prescribed, ask the prescriber about the indication, choice, dose, route of administration and duration of treatment, to understand if this is follows antibiotic guidelines [69]. 1.1481481481481481 d) antibiotikov, ki so jim ostali, nikoli ne delijo z drugimi. d) Never share leftover antibiotics with other people. 1.2698412698412698 c) nikoli ne uporabljajo antibiotikov, ki so jim ostali od preteklih zdravljenj; c) Never use leftover antibiotics from previous treatments; and 1.0138888888888888 Vaše naloge v zvezi z izboljšanjem rabe antibiotikov so [31,56,68,71,83]: Your tasks related to improving antibiotic use include [31,56,68,71,83]: 1.1428571428571428 Te bi morale biti pravočasno in zagotovo na voljo vsem izvajalcem zdravstvenih storitev [56,69]. These should be readily and reliably accessible to all healthcare providers [56,69]. 0.8660714285714286 Podpirajte razvoj in izvajanje programa za nadzor nad rabo antibiotikov v vaši organizaciji [69]. Support the development and implementation of an antibiotic stewardship programme within your organisation [69]. 1.1614906832298137 Redno usposabljajte zdravnike, ki predpisujejo zdravila, o preudarni rabi antibiotikov in sodelujte na srečanjih o izvajanju z dokazi podprtih bolnišničnih smernic o antibiotikih [31,53]. Regularly train hospital prescribers on prudent antibiotic use and participate in meetings on implementing evidence-based hospital antibiotic guidelines [31,53]. 0.5714285714285714 Ključna sporočila za infektologe Key messages for hospital infectious disease specialists 0.96875 b) sodelovanje z bolnišničnim farmacevtom in kliničnim mikrobiologom pri izvajanju programa za nadzor nad rabo antibiotikov; b) Collaborating with the hospital pharmacist and the clinical microbiologist to implement the antibiotic stewardship programme; 1.3 Zdravnikom, ki predpisujejo zdravila, zagotovite povratne informacije in nasvete o diagnostični oceni ter zdravljenju nalezljivih bolezni [83]. Provide feedback and advice to prescribers on diagnostic evaluation and treatment of infectious diseases [83]. 1.0 Spodbujajte lokalne smernice o zdravljenju okužb in rabi antibiotikov. Promote local guidelines on managing infections and using antibiotics. 1.2352941176470589 f) izmenjavanje informacij o lokalnih mikrobioloških vzorcih in vzorcih odpornosti proti antibiotikom ter f) Sharing information on local microbiology and antibiotic resistance patterns; and, 1.2975206611570247 c) posvetovanje z zdravniki, ki predpisujejo zdravila v bolnišnici, in posredovanje povratnih informacij, da se zagotovi kakovost predpisovanja antibiotikov; c) Consulting with hospital prescribers and providing them with feedback to ensure the quality of antibiotic prescribing; 1.3228346456692914 d) izobraževanje zdravnikov, ki predpisujejo zdravila v bolnišnici, o tem, kako diagnosticirati in zdraviti pogoste okužbe, ter o načelih nadzora nad rabo antibiotikov; d) Educating hospital prescribers on how to diagnose and treat common infections, and on the antibiotic stewardship principles; 1.0353982300884956 e) izvajanje z dokazi podprtih bolnišničnih smernic za rabo antibiotikov pri pogostih okužbah in kirurški profilaksi; e) Implementing evidence-based hospital antibiotic guidelines for common infections and for surgical prophylaxis; 0.5360824742268041 g) vodenje bolnišničnega kataloga antibiotikov (npr. g) Managing your hospital's antibiotic formulary (i.e., list of drugs available for prescribers). 2.3636363636363638 zdravstveni delavci v primarnem zdravstvenem varstvu primary care providers 1.162162162162162 Uporablja se lahko kot povzetek dejstev ali namizni opomnik med zdravniškimi pregledi. It can be used as a fact sheet or as a desk reminder during consultations. 0.5806451612903226 Pogovor z bolnikom Twitter Facebook Linked In Mail 1.0746268656716418 Poleg tega se lahko zdravstveni sistemi razlikujejo od države do države. In addition, healthcare systems can differ from country to country. 0.9084967320261438 Ključna sporočila je treba tudi natančno prilagoditi, saj imajo zdravstveni delavci po Evropi morda drugačne vloge od opisanih v dokumentu. The key messages need to be carefully adapted as well, since professionals across Europe might have different roles than those described in the document. 0.9742489270386266 Pomembno je poudariti, da predloge v gradivu vsebujejo bistvene informacije in splošna sporočila, vendar bodo najučinkovitejše, če jih prilagodite potrebam in razmeram v posamezni državi ali celo posamezni zdravstveni ustanovi. It is important to stress that the template materials provide a core of information and common messages but will be most effective if adapted to respond to the needs and situations in each country, or even in each healthcare setting. 1.089430894308943 Vprašanja glede odpornosti proti antibiotikom v bolnišnicah in drugih zdravstvenih ustanovah se lahko od države do države razlikujejo. The issues surrounding antibiotic resistance in hospitals and other healthcare settings may differ from country to country. 1.1075949367088607 Poleg tega je gradivo namenjeno ustvarjanju občutka osebne odgovornosti pri reševanju vprašanja odpornosti proti antibiotikom in spodbujanju zdravstvenih delavcev k ukrepanju. Moreover, the materials aim at creating a sense of individual responsibility in tackling antibiotic resistance and at empowering professionals to take action. 1.2696629213483146 Nabor orodij vsebuje: ključna sporočila, kontrolni seznam za predpisovalce zdravil, informativne liste, infografiko o smotrni rabi antibiotikov, letake, dopise, plakate, predstavitve in kartice s profili na družbenih omrežjih. The toolkit includes: key messages, checklist for prescribers, factsheets, infographic about antibiotic stewardship, leaflets, letters, posters, presentation, social media cards. 0.96 - zdravstveni delavci na urgenci, v oddelkih intenzivne nege in ustanovah za dolgotrajno oskrbo. - Professionals in emergency departments, in intensive care units, and in long-term care facilities. 1.297872340425532 To se nanaša na sporazum med strokovnjaki centra ECDC, člani svetovalnega tehničnega odbora za evropski dan ozaveščanja o antibiotikih ter drugimi zunanjimi strokovnjaki in deležniki. This refers to the agreement reached by ECDC experts, EAAD Technical Advisory Committee members, and other external experts and stakeholders. 1.2448979591836735 - zdravstveni delavci za preprečevanje in obvladovanje okužb, - Infection prevention and control professionals, 1.372972972972973 Ključna sporočila za ta orodja temeljijo na temeljitem pregledu znanstvene literature, ki so ga opravili strokovnjaki Evropskega centra za preprečevanje in obvladovanje bolezni (ECDC), in so bila sestavljena po obsežnem postopku posvetovanja in urejanja. The key messages for this toolkit derived from a thorough review of the scientific literature by ECDC experts and were developed following an extensive consultation and editing process. 1.099056603773585 Cilj tega nabora orodij je zagotoviti podporo prizadevanjem za povečanje preudarne uporabe antibiotikov v bolnišnicah in drugih zdravstvenih ustanovah z razdeljevanjem izobraževalnega in informativnega gradiva, ki temelji na dokazih. The objective of this toolkit is to support efforts to increase prudent use of antibiotics in hospitals and other healthcare settings through dissemination of evidence-based educational and information materials. 0.9820627802690582 Glavno ciljno občinstvo teh orodij so zdravstveni delavci v bolnišnicah in drugih zdravstvenih ustanovah, kot so ustanove za dolgotrajno oskrbo, ki imajo drugačne vloge in vpliv pri uporabi antibiotikov v teh ustanovah: The primary target audience for this toolkit is professionals in hospitals and other healthcare settings, such as long-term care facilities, who have different roles and influence in the use of antibiotics in such settings. 0.8102189781021898 Nekatera sporočila ne vsebujejo sklicev na znanstveno literaturo, temveč imajo oznako „soglasje strokovnjakov". Some of the messages are indicated to be "expert consensus", instead of being linked to a reference taken from the scientific literature. 1.0551181102362204 Zdravstvene delavce spodbujamo, naj prilagodijo ključna sporočila in predloge v gradivu, da bodo ustrezala njihovim posebnim potrebam. Professionals are encouraged to mix and match the key messages and the template materials, to address their own specific needs. 1.0 Zakaj so nekatere države bolj ogrožene kot druge? Why are some countries more affected than others? 1.25 Povzetek dejstev za splošno javnost Factsheet for general public 1.105263157894737 Ali je problem resnejši kot v preteklosti? Is the problem worse than in the past? 0.8148148148148148 Kako resen je problem? How serious is the problem? 0.7894736842105263 Kako je problem mogoče rešiti? What can be done to solve the problem? 0.6984126984126984 Kakšna je odpornost v drugih območjih sveta? What is the resistance situation in other regions in the world? 0.8923076923076924 Kadar je mogoče, preprečite okužbo z ustreznim cepljenjem. When possible, prevent infection through appropriate vaccination. 1.288888888888889 Kako lahko zaščitim sebe/svojo družino pred okužbo z MRSA? How can I protect myself/my family from MRSA? 0.96045197740113 Če se okužite z MRSA, vprašajte svojega zdravnika ali medicinsko sestro, katere higienske ukrepe morate vi in družinski člani upoštevati v bolnišnici in po vrnitvi domov. If you catch an infection due to MRSA, ask your doctor or nurse about which hygiene measures you and your family will have to comply with, in hospital and when you go back home. 0.6811594202898551 Včasih lahko povzroča okužbe, če vstopi v telo. It may sometimes causes infections if it is introduced into the body. 0.8653846153846154 Ni vedno mogoče določiti, kolikšen delež odpornih okužb povzroča kateri od teh dejavnikov. It is not always possible to determine the proportion of resistant infections caused by a single factor. 0.9867109634551495 Svet Evropske unije je leta 2001 za rešitev te težave javnega zdravja izdal priporočilo, v katerem je države pozval k sprejemu ukrepov za zagotovitev preudarne uporabe antibiotikov (Priporočilo Sveta z dne 15. novembra 2001 o preudarni rabi protimikrobnih sredstev v humani medicini (2002/77/ES)). To address this public health concern, the Council of the European Union issued a recommendation in 2001 asking countries to put in place actions to ensure prudent use of antibiotics (Council recommendation of 15 November 2001 on the prudent use of antimicrobial agents in human medicine (2002/77/EC). 1.0618556701030928 Odpornost bakterije Escherichia coli na glavne antibiotike se povečuje v skoraj vseh evropskih državah. Escherichia coli resistance to major antibiotics is increasing in almost all countries in Europe. 0.9387755102040817 Odporna E. coli se lahko nato širi med ljudmi. Resistant E. coli may then spread between people. 1.1341463414634145 Običajno je MRSA, ki jo je mogoče najti v bolnišnicah, odporna na številne druge antibiotike. Typically, MRSA that is found in hospitals is resistant to many other antibiotics. 0.9076923076923077 Obstaja več kot 15 različnih razredov antibiotikov, ki se razlikujejo po kemijski sestavi in protibakterijskem učinku. There are more than 15 different classes of antibiotics that differ in their chemical structure and their action against bacteria. 0.8888888888888888 Uspešne kampanje za ozaveščanje javnosti, ki so že potekale v nekaterih državah, so prispevale k zmanjšanju porabe antibiotikov. Successful public awareness campaigns, which have already taken place in some countries, have resulted in a reduction of antibiotic consumption. 0.9583333333333334 Vsi lahko pomembno prispevamo k zmanjšanju odpornosti na antibiotike: Everyone can play an important role in decreasing antibiotic resistance: 1.3650793650793651 Podatki, pridobljeni s spremljanjem, kažejo, da predstavlja odpornost na protimikrobna zdravila čedalje večjo težavo za javno zdravje v evropskih bolnišnicah in skupnostih. Surveillance data show that antimicrobial resistance is a growing public health problem in European hospitals and communities. 1.1153846153846154 Bakterija Staphylococcus aureus je pogosta bakterija, prisotna na koži in v sluznici pri 20 % do 30 % zdravih ljudi. Staphylococcus aureus is a common bacterium, present on skin and mucosa in 20% to 30% of healthy people. 0.9242424242424242 Redno umivajte roke sebi in svojim otrokom, na primer po kihanju ali kašljanju pred dotikanjem drugih predmetov ali ljudi. Wash your hands and your children's hands regularly, for instance after sneezing or coughing before touching other things or people. 1.037037037037037 Bolnikom razložite, kako lahko lajšajo simptome prehlada in gripe brez antibiotikov. Explain to patients how to relieve symptoms of colds and flu without antibiotics. 0.9534883720930233 Kaj je »neustrezna« uporaba antibiotikov? What is "inappropriate" use of antibiotics? 1.0208333333333333 Nekatere bakterije so naravno odporne na nekatere antibiotike (notranja ali inherentna odpornost). Some bacteria are naturally resistant to certain antibiotics (intrinsic or inherent resistance). 0.8333333333333334 Antibiotik lahko učinkuje proti samo eni ali več vrstam bakterij. An antibiotic may be effective against only one or multiple types of bacteria. 0.9752066115702479 Bolnike poučite, zakaj je pomembno, da pri zdravljenju upoštevajo navodila zdravnika, ki jim je predpisal antibiotike. Advise patients why it is important that they comply with the treatment when they are prescribed antibiotics by a doctor. 1.0675675675675675 Takšne bakterije lahko nazadnje postanejo odporne na vse obstoječe antibiotike. Such bacteria may eventually become resistant to all existing antibiotics. 0.7886178861788617 Zato je treba vedeti, kdaj je primerno jemati antibiotike in kako jih je mogoče jemati odgovorno. On this basis, it is important to known when it is appropriate to take antibiotics and how to take antibiotics responsibly. 1.0096153846153846 To lahko prepreči pravočasno ustrezno zdravljenje bolnika, kar lahko povzroči zaplete, vključno s smrtjo. This may delay getting the right treatment to patients and may result in complications, including death. 1.0607734806629834 Ker se odpornost povečuje, v zadnjih letih pa je bilo razvitih in danih v promet le malo novih antibiotikov, predstavlja problem odpornosti na antibiotike zdaj glavno grožnjo za javno zdravje. Because resistance is increasing and few new antibiotics have been discovered and marketed in recent years, the problem of antibiotic resistance is now a major public health threat. 1.0677083333333333 Medtem ko v državah v razvoju ljudje še vedno umirajo zaradi pomanjkanja ustreznega zdravljenja z antibiotiki, je odpornost na antibiotike zaradi neustrezne uporabe razlog za zaskrbljenost na vseh celinah. While people still die in developing countries because they lack the correct antibiotic treatment, antibiotic resistance resulting from inappropriate use is causing concern in every continent. 1.2765957446808511 Ali so povezani z antibiotiki, ki se uporabljajo pri ljudeh? Are they related to antibiotics used in humans? 1.125 Neustrezna uporaba antibiotikov je težava globalne razsežnosti. Inappropriate use of antibiotics is a problem worldwide. 0.9166666666666666 Katere bolezni povzročajo odporne bakterije? Which diseases are caused by resistant bacteria? 1.2755102040816326 Kadar je mogoče, predpišite antibiotik, ki je specifičen za posamezno okužbo, in ne antibiotika s širokim spektrom delovanja. When possible, prescribe an antibiotic that is specific to the infection and not "broad spectrum". 1.3658536585365855 Antibiotike predpisujte le, kadar je treba, in sicer v skladu s smernicami, ki temeljijo na preteklih izkušnjah. Prescribe antibiotics only when necessary, according to evidence-based guidelines. 0.9833333333333333 Za ohranjanje učinkovitosti antibiotikov smo odgovorni vsi. Keeping antibiotics effectives is everyone's responsibility. 0.9767441860465116 Odpornost na antibiotike je naravni pojav, ki nastane zaradi mutacij genov bakterij. Antibiotic resistance is a natural occurrence caused by mutations in bacteria's genes. 1.0206185567010309 Nekatere države so že pred nekaj leti oblikovale nacionalne programe, vključno s kampanjami za ozaveščanje javnosti, ter poročale o zmanjšanju tako porabe antibiotikov kot odpornosti na antibiotike. Some countries launched national programmes, including public awareness campaigns, several years ago and have observed a decrease in both consumption of antibiotics and in antibiotic resistance. 0.926829268292683 Predel okužbe je odvisen od vrste bakterije in zdravstvenega stanja bolnika. The location of the infection depends on the bacteria and the patient's condition. 1.3870967741935485 Iz podatkov evropskega sistema za spremljanje odpornosti na protimikrobna zdravila ( http://www.rivm.nl/earss/ ) je razvidno, da se odpornost postopno povečuje od severa proti jugu, pri čemer je za skandinavske države in Nizozemsko značilna nizka stopnja, za južno Evropo pa visoka stopnja odpornosti. Data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) show that there is a gradient North-South with low rates in Scandinavian countries and the Netherlands and high rates in Southern Europe. 0.9779411764705882 Pred odkritjem antibiotikov je na tisoče ljudi umiralo zaradi bakterijskih okužb, kot sta pljučnica ali okužba po operativnem posegu. Before the discovery of antibiotics, thousands of people died from bacterial diseases, such as pneumonia or infection following surgery. 1.1210191082802548 Zdravljenje okužb, ki jih povzročajo odporne bakterije, je izziv: antibiotiki, ki se običajno uporabljajo, niso več učinkoviti, zato morajo zdravniki izbrati druge antibiotike. Treating infections due to resistant bacteria is a challenge: antibiotics commonly used are no longer effective and doctors have to choose other antibiotics. 0.4444444444444444 farmacevti in medicinske sestre: Doctors and other healthcare professionals, e.g. pharmacists and nurses: 0.975 Ali uporaba antibiotikov pri živalih za proizvodnjo živil prispeva k problemu? Does the use of antibiotics in food-producing animals contribute to the problem? 1.2641509433962264 Kateri antibiotiki se uporabljajo pri živalih za proizvodnjo živil? Which antibiotics are used in food-producing animals? 0.8723404255319149 V preteklih letih so poročali o povečanju števila okužb z E. coli, odporno na več antibiotikov hkrati, vključno s flourokinoloni in cefalosporini tretje generacije. In recent years, an increase in infections due to E. coli resistant to many antibiotics at the same time, including fluoroquinolones and third-generation cephalosporins, has been reported. 0.9387755102040817 E. coli je običajno neškodljiva, vendar lahko včasih povzroči okužbe, predvsem okužbe sečil. E. coli is generally harmless but may sometimes cause infections, mainly urinary tract infections. 1.1538461538461537 Antibiotiki, znani tudi kot protimikrobna zdravila, so zdravila, ki lahko ubijejo bakterije ali zaustavijo njihovo rast in s tem ozdravijo okužbe pri ljudeh, živalih in včasih tudi pri rastlinah. Antibiotics, also known as antimicrobial drugs, are medicines that can kill or inhibit the growth of bacteria to cure infections in people, animals and sometimes plants. 0.9902912621359223 MRSA se prenaša predvsem ob neposrednem stiku med ljudmi ali s priborom oz. z zdravstvenimi napravami. MRSA is mainly acquired through direct contact from human to human or via equipment or medical devices. 1.049079754601227 Bolj zaskrbljujoče je, da nekatere bakterije, ki so v normalnih okoliščinah občutljive na antibiotike, postanejo odporne zaradi genetskih sprememb (pridobljena odpornost). A more worrying problem is when some bacteria, that are normally susceptible to antibiotics, become resistant as a result of genetic changes (acquired resistance). 1.19 Antibiotiki, ki se uporabljajo za zdravljenje in preprečevanje bakterijskih okužb pri živalih, sodijo v iste kemijske skupine kot antibiotiki, ki se uporabljajo pri ljudeh: makrolidi, tetraciklini, kvinoloni, beta laktami, aminoglikozidi. Antibiotics used to treat and prevent bacterial infections in animals belong to the same chemical groups as those used for humans: macrolides, tetracyclines, quinolones, beta-lactams, aminoglycosides. 1.2131147540983607 Brez antibiotikov bi se vrnili v obdobje, ko antibiotikov brez katerih presaditve organov, kemoterapija pri zdravljenju rakavih obolenj, intenzivna nega in drugi zdravstveni postopki ne bi bili več mogoči, še niso poznali. Without antibiotics, we could return to the "pre-antibiotic era", when organ transplants, cancer chemotherapy, intensive care and other medical procedures would no longer be possible. 1.1688741721854305 Neustrezna uporaba pomeni tudi nepravilno uporabo antibiotikov: če skrajšate trajanje zdravljenja, zmanjšate odmerke, antibiotikov ne jemljete tako pogosto, kot je predpisano (zdravilo vzamete enkrat na dan namesto 2- ali 3-krat na dan, kot je predpisano), v telesu nimate zadostne količine zdravila, zato bakterije preživijo in lahko postanejo odporne. When you use antibiotics incorrectly: if you shorten the duration of treatment, lower the doses, don't comply with the right frequency (taking the drug once a day instead of 2 or 3 times a day as directed), you won't have enough drug in your body and the bacteria will survive and may become resistant. 1.0091743119266054 Ne glede na to je glavni razlog za odpornost na antibiotike pri ljudeh uporaba antibiotikov v humani medicini. However, the major cause of antibiotic resistance in humans remains the use of antibiotics in human medicine. 1.0316455696202531 V državah z nižjo stopnjo odpornosti je poraba antibiotikov običajno manjša, medtem ko je v državah z višjo stopnjo odpornosti na antibiotike njihova poraba večja. Countries with lower resistance rates have generally lower use of antibiotics, whereas countries with higher antibiotic resistance rates use more antibiotics. 0.9603174603174603 Vendar pa prekomerna in neustrezna uporaba antibiotikov pospešuje nastanek in širjenje bakterij, odpornih na antibiotike. However, excessive and inappropriate use of antibiotics accelerates the emergence and spread of antibiotic-resistant bacteria. 0.7969924812030075 Svetovna zdravstvena organizacija (SZO) je objavila globalno strategijo in smernice za pomoč državam pri vzpostavljanju sistemov za spremljanje odpornosti na antibiotike in pri izvajanju učinkovitih ukrepov (npr. The World Health Organization (WHO) issued a global strategy and guidelines to help countries in setting up systems to monitor antibiotic resistance and to implement efficient actions (for instance, insuring that antibiotics can only be purchased with prescription). 1.4094488188976377 V takšnem primeru zdravstvenega stanja ne boste izboljšali z jemanjem antibiotikov: antibiotiki ne znižajo povišane telesne temperature, niti ne lajšajo simptomov, kot je kihanje. In such cases, you won't improve your condition by taking antibiotics: antibiotics don't lower fever or symptoms like sneezing. 1.0419847328244274 Antibiotiki so zdravila proti bakterijskim okužbam (kot so pnevmokokna pljučnica ali okužbe krvnega obtoka s stafilokoki); protimikrobna zdravila, ki učinkujejo proti virusom, se običajno imenujejo protivirusna zdravila (kot so zdravila proti gripi, virusu HIV in herpesu). Antibiotics are medicines for bacterial infections (such as pneumococcal pneumonia or staphylococcal bloodstream infections); antimicrobial drugs that are effective against viruses are usually called antiviral drugs (such as those for influenza, HIV and herpes). 1.04 Odgovorna uporaba antibiotikov lahko pomaga zaustaviti širjenje odpornih bakterij in ohraniti učinkovitost antibiotikov za uporabo v prihodnjih generacijah. Responsible use of antibiotics can help stop resistant bacteria from developing and help keep antibiotics effective for the use of future generations. 1.2333333333333334 Vedno uporabljajte antibiotike, ki vam jih je predpisal zdravnik; ne uporabljajte ostankov zdravil ali antibiotikov, ki ste jih dobili brez recepta. Always use antibiotics under medical prescription, not using "leftovers" or antibiotics obtained without a prescription. 0.9537037037037037 Te odporne bakterije se lahko širijo in povzročajo okužbe tudi pri osebah, ki niso jemale antibiotikov. These resistant bacteria may spread and cause infections in other people who have not taken any antibiotics. 1.2121212121212122 Neustrezna uporaba pomeni uporabo antibiotikov v napačen namen: večino prehladov in primerov gripe povzročajo virusi, proti katerim antibiotiki NISO učinkoviti. When you use antibiotics for the wrong reason: most colds and flu are caused by viruses against which antibiotics are NOT effective. 0.9115384615384615 Najbolje lahko sebe in svojo družino pred MRSA zaščitite tako, da upoštevate preproste higienske ukrepe: očistite in pokrijte rane, ureznine in praske, vzdržujte čistočo rok, dokler se ne zacelijo, ter si ne izmenjujte britev ali brisač. The most important thing to protect yourself and your family from MRSA is to comply with simple hygiene measures: clean and cover wounds, cuts and scrapes, keep your hands clean until they are healed, and avoid sharing personal items such as razors and towels. 1.0810810810810811 E. coli lahko dobite tudi z neposrednim stikom z drugo osebo (prek stiska roke). It may also be transmitted from another person via direct contact (hands). 0.9615384615384616 Vsak antibiotik ne učinkuje proti vsaki bakteriji. Not all antibiotics are active against all bacteria. 1.6153846153846154 Kako se prenaša MRSA? What is MRSA? 1.1219512195121952 Odporne bakterije preživijo tudi ob prisotnosti antibiotikov in se še naprej širijo, kar podaljša trajanje bolezni ali povzroči celo smrt. Resistant bacteria survive in the presence of the antibiotic and continue to multiply causing longer illness or even death. 1.1875 Odpornost na antibiotike pri živalih za proizvodnjo živil Antibiotic resistance and food-producing animals 1.1142857142857143 Razlike v stopnji odpornosti povzročajo številni dejavniki, vključno z uporabo antibiotikov, vrsto zdravljenih bolezni, kakovostjo bolnišnične oskrbe, stopnjo imunizacije in družbenimi dejavniki. There are many reasons for different rates of resistance that can include antibiotic use, underlying diseases, quality of hospital care, immunisation rates and social factors. 1.1319444444444444 Bakterija Staphylococcus aureus, ki je odporna na meticilin (ali na oksacilin, vrsto penicilina), se imenuje MRSA ali „na meticilin odporni Staphylococcus aureus". When it is resistant to methicillin (or to oxacillin, a type of penicillin), it is called MRSA or "Methicillin-Resistant Staphylococcus aureus". 1.0888888888888888 Ali je odpornost na antibiotike v Evropi problem? Is antibiotic resistance a problem in Europe? 1.0789473684210527 Odporne bakterije se lahko prenesejo na ljudi tudi ob neposrednem stiku z živalmi. People may also acquire resistant bacteria from direct contact with animals. 1.146153846153846 Bolnik utegne poleg tega potrebovati več pozornosti ter zdravljenje z drugačnimi in dražjimi antibiotiki, ki utegnejo imeti resnejše neželene učinke. Also, a patient may need more care as well as alternative and more expensive antibiotics, which may have more severe side effects. 1.0049751243781095 Potem ko so odkrili antibiotike in jih začeli uporabljati, je postalo vedno več bakterij, ki so bile sprva občutljive, odpornih, poleg tega so razvile številne načine, kako izničiti učinke antibiotikov. Since antibiotics have been discovered and used, more and more bacteria, which were originally susceptible, have become resistant and developed numerous different means of fighting against antibiotics. 0.9128205128205128 V bolnišnicah lahko MRSA preide v kri ali druga telesna tkiva kadar koli med oskrbo, zlasti ob izvajanju invazivnih postopkov, kot so operativni poseg, injekcije in predihavanje. In hospitals, MRSA may be introduced in blood or other tissue in the body on several occasions during care, especially when performing invasive procedures such as surgery, injection, ventilation. 0.9310344827586207 Kaj je najpomembnejši vzrok odpornosti na antibiotike? What is the most important cause of antibiotic resistance? 1.0210526315789474 Glavni dejavnik tveganja odporne E. coli zunaj bolnišnice je predhodno zdravljenje z antibiotiki. The main risk factors for resistant E. coli in the community are previous antibiotic treatment. 1.1306451612903226 Bolniki, ki se zdravijo v bolnišnici, so izpostavljeni tveganju za okužbe, ki niso povezane z razlogom za sprejem v bolnišnico, vključno z okužbami krvnega obtoka in mesta operativnega posega, kot je MRSA (povzroča jo bakterija Staphylococcus aureus, odporna na meticilin; meticilin je antibiotik, ki je običajno učinkovit proti Staphylococcus aureus), okužbami z bakterijo Enterobacteriaceae, ki izloča ESBL (beta laktamaze razširjenega spektra; gre za encime, ki lahko izničijo učinek nekaterih antibiotikov), okužbami srčnih zaklopk zaradi bakterije Enteroccocci, odporne na vankomicin, ter okužbami mesta operativnega posega in ran zaradi bakterije Acinetobacter baumannii, odporne na karbapeneme. Patients in hospitals are at risk for infections unrelated to the reason for admission, including bloodstream and surgical site infections like MRSA (caused by Staphylococcus aureus resistant to methicillin, an antibiotic representative of those which are usually effective against Staphylococcus aureus), bloodstream infections caused by Enterobacteriaceae producing ESBL (extended-spectrum beta-lactamases, enzymes able to destroy some antibiotics), heartvalve infections caused by Enteroccocci resistant to vancomycin, and surgical site and wound infections caused by Acinetobacter baumannii resistant to carbapenems. 1.0869565217391304 Visoko tveganje za prenos MRSA lahko predstavlja tudi uporaba antibiotikov. Antibiotic use is also associated with higher risk of acquiring MRSA. 0.8507462686567164 Običajno je za to okužbo značilen tesen stik med osebami. Common characteristic appears to be close person-to-person contact. 1.1472868217054264 O odpornosti bakterij na antibiotike govorimo takrat, ko nekateri antibiotiki izgubijo sposobnost, da uničijo bakterije ali zaustavijo njihovo rast. Bacteria have antibiotic resistance when specific antibiotics have lost their ability to kill or stop the growth of the bacteria. 1.25 Kakšna so tveganja za okužbo z MRSA v bolnišnicah? What are the risks of MRSA in hospitals? 1.1210191082802548 Okužbe, ki jih povzročajo odporne bakterije, utegnejo zahtevati več pozornosti ter zdravljenje z drugačnimi in dražjimi antibiotiki, ki utegnejo imeti resnejše neželene učinke. Infections caused by resistant bacteria may require more care as well as alternative and more expensive antibiotics, which may have more severe side effects. 1.0769230769230769 Zakaj je odpornost na antibiotike problem? Why is antibiotic resistance a problem? 0.59 iz atletskih društev in zaporov v Severni Ameriki, poleg tega je bil ugotovljen tudi prenos okužbe na družinske člane. Community-associated MRSA (CA-MRSA) infections have been described in several countries, e.g. in athletic teams and prisons in North America, and transmission has been documented among family members. 0.46296296296296297 Campylobacter ali Salmonella, se lahko prenesejo z živali na ljudi s hrano. Certain resistant bacteria that are associated with food consumption, such as Campylobacter or Salmonella, may be transferred from animals to humans through food. 1.1801470588235294 Za zmanjšanje tovrstnega tveganja se v bolnišnicah izvajajo preventivni ukrepi: umivanje rok ali razkuževanje z alkoholno raztopino, uporaba antiseptikov pred izvajanjem operativnih posegov, presejanje in osamitev bolnikov, pri katerih je visoko tveganje prisotnosti odporne bakterije, ter preudarna uporaba antibiotikov. To reduce this risk, hospitals put in place preventive actions: hand-washing or disinfection with alcohol-based solution, antisepsis before performing surgery, screening and isolation of patients at high risk of carrying resistant bacteria, and prudent use of antibiotics. 1.1481481481481481 Za zmanjšanje tovrstnega tveganja se v bolnišnicah izvajajo preventivni ukrepi: preudarna uporaba antibiotikov, antiseptiki pred izvajanjem operativnih posegov, aseptični postopki za preprečevanje okužb sečil, higiena rok ter presejanje bolnikov, pri katerih je tveganje za prisotnost odpornih bakterij visoko. To reduce this risk, hospitals put in place preventive actions: prudent use of antibiotics, antisepsis before performing surgery, aseptic procedures to prevent urinary tract infections, hand hygiene, and screening of patients at high risk of carrying resistant bacteria. 0.81 zunaj bolnišnice se lahko okužite z MRSA, če ta vstopi v telo skozi rano na koži. In the community, MRSA infections may occur if MRSA is introduced into the body through broken skin. 1.049645390070922 Običajno povzroča okužbe kože in ran, lahko pa tudi okužbe pljuč, mesta operativnega posega, krvnega obtoka, srca, kosti ter druge invazivne okužbe. It typically causes skin and wound infections but can cause pulmonary, surgical site, bloodstream, heart, bone and other invasive infections. 1.0943396226415094 Kakšna so tveganja okužbe z odporno E. coli v bolnišnicah? What are the risks of resistant E. coli in hospitals? 0.9253731343283582 O odstranjevanju ostankov zdravil se posvetujte s farmacevtom. Ask your pharmacist about how to dispose of the remaining medicines 0.6086956521739131 Učinkovito zdravljenje okužbe sečil z odporno E. coli se utegne zakasniti, kar lahko povzroči hude zaplete, npr. Getting an effective treatment for urinary tract infection due to resistant E. coli may be delayed, possibly resulting in serious complications such as kidney or bloodstream infection. 0.8242424242424242 Položaj se s pojavom novih sevov bakterij, odpornih na več antibiotikov hkrati (gre za bakterije, odporne na več zdravil), le še slabša. The situation is getting worse with the emergence of new bacterial strains resistant to several antibiotics at the same time (known as multidrug-resistant bacteria). 1.0769230769230769 Pri jemanju antibiotikov upoštevajte navodila zdravnika. Follow your doctor's advice when taking antibiotics. 1.0666666666666667 Kaj je odpornost na antibiotike? What is antibiotic resistance? 0.9739130434782609 Ta bakterija povzroča okužbe sečil in resnejše okužbe ter sodi med bakterije, ki najpogosteje povzročajo okužbe. E. coli causes urinary tract and more serious infections and is one of the most common bacteria causing infections. 1.1440677966101696 Antibiotiki občutljive bakterije uničijo, medtem ko odporne bakterije ob izpostavljenosti antibiotikom še naprej rastejo in se množijo. When exposed to antibiotics, susceptible bacteria are killed and resistant bacteria can continue to grow and multiply. 0.926829268292683 Kaj privede do pojava odporne E. coli? What are the causes of resistant E. coli? 0.9605263157894737 Bakterije, ki so odporne na več zdravil, lahko povzročijo številne okužbe: okužbo sečil, pljučnico, kožne okužbe, drisko in okužbe krvnega obtoka. Multidrug-resistant bacteria can cause a wide range of infections: urinary tract infection, pneumonia, skin infection, diarrhoea, bloodstream infection. 0.48360655737704916 s flourokinoloni, povečuje tveganje pojava odporne E. coli. Previous antibiotic treatment, e.g. with fluoroquinolones, has been associated with higher risks of resistance in E. coli. 1.0384615384615385 Bakterijske okužbe bi se širile in povzročale smrt, saj bi postale neozdravljive. Bacterial diseases would spread and could no longer be treated, causing death. 1.1700680272108843 Tako pridobljena MRSA lahko povzroči lokalne kožne okužbe ali življenjsko nevarnejše okužbe, kot so pljučnica, okužbe krvnega obtoka in okužbe na mestu operativnega posega. It can then cause local skin infections or more life-threatening infections such as pneumonia, bloodstream infections and surgical site infections. 1.1285714285714286 Glede časa in načina jemanja antibiotikov vedno upoštevajte navodila zdravnika. Always follow your doctor's advice on when and how to use antibiotics. 1.2293577981651376 To pomeni, da se lahko bakterije, odporne na antibiotike, ki se uporabljajo tudi za zdravljenje okužb ljudi, prenesejo tudi na živali. Therefore, animals may acquire bacteria that are resistant to antibiotics also used against human infections. 0.9166666666666666 Odpornost na antibiotike v Evropi The problem of antibiotic resistance 0.5226130653266332 Escherichia coli ali E. coli sodi med najpogostejše bakterije v prebavilih (črevesju) vsakega izmed nas. Escherichia coli or E. coli is one of the most common bacteria in the digestive tract (gut) of each of us. It belongs to a family of bacteria called Enterobacteriacae (with Klebsiella, Enterobacter). 0.9055555555555556 Po vsej Evropi že potekajo različne pobude za razširjanje zavedanja o tveganjih povezanih z neprimerno rabo antibiotikov ter o tem, kako jih preudarno uporabljati. A number of initiatives are taking place across Europe to spread the messages on the risks associated with inappropriate use of antibiotics and how to take antibiotics responsibly. 0.1320754716981132 Hrvaška National Center of Infecctious and Parasitic Diseases 0.15789473684210525 Bolgarija Belgian Antibiotic Policy Coordination Committee (BAPCOC) 1.019047619047619 f) ponovno presojo o zdravljenju po 48-72 urah oziroma potem, ko so znani rezultati mikrobioloških vzorcev; f) Re-evaluating treatment after 48-72 hours, or when results from microbiological samples are available; 0.8314606741573034 g) čim hitrejša uvedba zdravljenja z antibiotiki za bolnike s hudo okužbo; g) Initiating antibiotic treatment as soon as possible in patients with severe infection; 1.0 j) sodelovanje na letnih usposabljanjih o preudarni rabi antibiotikov. j) Participating in annual training courses on prudent antibiotic use. 0.98989898989899 i) obveščanje bolnika o vseh predpisanih antibiotikih in njihovih morebitnih neželenih učinkih ter i) Informing your patients of any antibiotics prescribed, and their potential adverse effects; and, 0.896551724137931 Poskrbite za dobro obveščanje bolnikov in jim pomagajte razumeti pomembnost preudarne rabe antibiotikov. Be a good source of information for your patients and help them understand the importance of prudent antibiotic use. 1.1923076923076923 d) upoštevanje navodil za preprečevanje in obvladovanje okužb; d) Follow infection prevention and control guidance; 0.9769585253456221 Če ugotovite, da je zdravstveni delavec v bolnišnici ali zdravstveni ustanovi kršil smernice oziroma protokole, ga vprašajte, zakaj je tako ravnal, in mu pomagajte razumeti, kaj dela narobe [strokovno usklajeno]. If you see staff members at the hospital or healthcare setting who breach guidelines or protocols, ask them why they are doing so and provide them with tools to understand what they are doing wrong [expert consensus]. 1.2269938650306749 Poskrbite, da bodo bolniki (in njihovi družinski člani) razumeli razloge za zdravljenje z antibiotiki ter ključne točke v zvezi z rabo antibiotikov, pri čemer jih opozorite, naj [strokovno usklajeno]: Ensure that patients (and their families) understand the reasons for antibiotic therapy, and key points related to antibiotic use, including to [expert consensus]: 1.0218340611353711 c) Ali ste preverili nedavno rabo antibiotikov, alergije na zdravila, rabo imunosupresivnih zdravil, nedavno hospitalizacijo ali institucionalizacijo, nedavno potovanje zunaj Evrope in mikrobiološke rezultate v preteklih treh mesecih? c) Have you checked for recent antibiotic use, drug allergies, use of immunosuppressive therapy, recent hospitalisation or institutionalisation, recent travel outside of Europe, and microbiology results for the previous 3 months? 1.1694915254237288 h) upoštevanje lokalnih mikrobioloških vzorcev in vzorcev odpornosti proti antibiotikom pri uvedbi empiričnega antibiotičnega zdravljenja; h) Considering local microbiology and antibiotic resistance patterns when prescribing empirical antibiotic treatments; 1.0193548387096774 Po potrebi se posvetujte s skupino za nadzor nad rabo antibiotikov, npr., kadar predpisujete antibiotik izven običajnih smernic [31,56] [strokovno usklajeno]. Consult the antibiotic stewardship team when needed, for examples when you prescribe an antibiotic outside of normal guidelines [31,56] [expert consensus]. 1.148936170212766 Sledite protokolom za zdravljenje z antibiotiki na podlagi smernic, ki temeljijo na dokazih, ter izvajajte ukrepe za preprečevanje in obvladovanje okužb, ki so vzpostavljeni v vašem okolju [31] [strokovno usklajeno]. Follow antibiotic treatment protocols, based on evidence-based guidelines, and apply infection prevention and control measures that are established in your setting [31] [expert consensus]. 1.0030674846625767 b) upoštevanje ustrezne anamneze posameznega bolnika pri presoji potrebe po rabi antibiotika, vključno z nedavno rabo antibiotikov, alergijami na zdravila, uporabo imunosupresivnih zdravil, nedavno hospitalizacijo ali institucionalizacijo, nedavnim potovanjem zunaj Evrope in mikrobiološkimi rezultati v preteklih treh mesecih; b) Identifying relevant individual patient background when evaluating the need for an antibiotic prescription, including recent antibiotic use, drug allergies, use of immunosuppressive therapy, recent hospitalisation or institutionalisation, recent travel outside of Europe, and microbiology results for the previous 3 months; 1.1261682242990654 Ponovna presoja prvotnega antibiotičnega zdravljenja po 48-72 urah in prehod s parenteralnega na peroralno zdravljenje (kadar je to mogoče) zmanjšata stopnjo odpornosti proti antibiotikom in izboljšata klinične rezultate [37,54,57,71,92,93]. Reviewing initial antibiotic treatment after 48-72 hours and switching from parenteral to oral administration (when possible), reduces antibiotic resistance rates and improves clinical outcomes [37,54,57,71,92,93]. 1.2459016393442623 S posvetovanjem s skupino za nadzor nad rabo antibiotikov se poveča kakovost predpisovanja zdravil in izboljšajo rezultati zdravljenja bolnikov [56,83]. Consulting the antibiotic stewardship team increases the quality of drug prescribing and improves patient outcome [56,83]. 1.104 a) predpisovanje v skladu z bolnišničnimi smernicami o antibiotikih, ki temeljijo na dokazih, pri pogostih okužbah in kirurški profilaksi; a) Prescribing according to evidence-based hospital antibiotic guidelines for common infections and for surgical prophylaxis; 1.0441988950276244 Časovna usklajenost in optimalno trajanje antibiotične profilakse za kirurški poseg vodi do manjšega števila okužb kirurških ran in zmanjša pojav bakterij, odpornih proti antibiotikom [73]. Correct timing and optimal duration of antibiotic prophylaxis for surgery leads to fewer surgical site infections, and decreases the emergence of antibiotic-resistant bacteria [73]. 1.1376811594202898 S predpisovanjem najkrajšega trajanja zdravljenja z antibiotiki, ki temelji na dokazih, se zmanjša pojav bakterij, odpornih proti antibiotikom [54,56,71,91]. Prescribing the shortest evidence-based duration of antibiotic treatment reduces emergence of antibiotic-resistant bacteria [54,56,71,91]. 1.3703703703703705 Naloge zdravnikov, ki predpisujejo zdravila v bolnišnicah, so povezane z izboljšanjem rabe antibiotikov in vključujejo [31,42,43,52-54,56,70,71,90]: As hospital prescribers your tasks related to improving antibiotic use include [31,42,43,52-54,56,70,71,90]: 1.177142857142857 Odvzem mikrobioloških vzorcev pred začetkom empiričnega antibiotičnega zdravljenja in usmerjeno antibiotično zdravljenje na podlagi rezultatov kultur pripomoreta k preudarnejši rabi antibiotikov [31,70,71]. Taking microbiology samples before starting empirical antibiotic therapy and streamlining antibiotic treatment based on culture results help improve antibiotic use [31,70,71]. 1.2953020134228188 Zaradi prehoda s parenteralnega na peroralno zdravljenje z antibiotiki, ki ga je vodil farmacevt, se je skrajalo parenteralno zdravljenje brez negativnih posledic na rezultate zdravljenja [56]. A pharmacist-led parenteral-to-oral switch resulted in shortened parenteral therapy durations without negatively impacting on clinical outcomes [56]. 1.103896103896104 Dokumentiranje indikacije, izbire zdravil, odmerka, načina dajanja zdravila in trajanja zdravljenja v bolnikovi kartoteki pripomore k preudarnejši rabi antibiotikov [71]. Documenting indication, drug choice, dose, route of administration and duration of treatment in the patient chart leads to better use of antibiotics [71]. 0.6847826086956522 Intervencije infektologov vplivajo na znatno izboljšanje kakovosti predpisovanja antibiotikov in zmanjšanje njihove rabe [83]. Infectious disease specialist interventions have been associated with a significant improvement in the quality of antibiotic prescribing and leading a reduction in antibiotic use [83]. 1.4631578947368422 Z upoštevanjem navodil glede rabe antibiotikov in sodelovanjem pri izobraževalnih vizitah se bo predpisovanje antibiotikov izboljšalo [78]. Using antibiotic guidance and attending educational rounds improve antibiotic prescribing [78]. 1.1369863013698631 e) zagotavljanje, da se pred zdravljenjem z antibiotiki odvzamejo ustrezne kužnine; e) Ensuring that relevant cultures are taken before starting antibiotics; 0.8839779005524862 c) pri predpisovanju antibiotika v bolnikovi kartoteki dokumentiranje zdravljenja z antibiotiki, vrsto zdravila, način dajanja zdravila in trajanje zdravljenja; c) Documenting the indication for antibiotic treatment, drug choice, dose, route of administration and duration of treatment, in the patient chart, when you prescribe an antibiotic; 0.9333333333333333 Center ECDC ne želi spodbujati pretirane uporabe vrečk, ker si večina držav prizadeva odvračati od njihove uporabe zaradi zmanjšanja nepotrebnih odpadkov. ECDC does not want to encourage in any way the overuse of bags, as in most countries there is an effort to discourage their use in order to reduce unnecessary waste. 0.9182879377431906 Vendar je jasno, da so v nekaterih državah farmacevtske vrečke postale „skoraj trajna embalaža" za zdravila in zdravstvene kartoteke ter bi bilo zato mogoče nanje natisniti slikovno gradivo in sporočila o preudarni uporabi antibiotikov. Nevertheless, it is clear that is some countries pharmacy bags become a sort of "semi-permanent container" of medicines and of medical records and therefore could be used to print one of the visuals and promote the message related to prudent antibiotic use. 0.6296296296296297 Lekarniške vrečke Pharmacy bags: Antibiotics. 1.3015873015873016 Izsledki so povzeti v treh člankih, objavljenih v spletni reviji Eurosurveillance: The findings are summarised in three Eurosurveillance articles: 0.9024390243902439 Delež antibiotikov širokega spektra se je v Evropi gibal med 16 % in 62 %. The proportion of broad-spectrum antibiotics varied from 16% to 62% across Europe. 0.9594594594594594 Ključna sporočila temeljijo na rezultatih raziskav točkovne prevalence. The key messages are based on the results of the point prevalence surveys. 1.027027027027027 Zaradi velikih razlik v njihovi uporabi je treba pregledati njihove indikacije v številnih državah in bolnišnicah. The wide variation in their use indicates the need to review their indications in many countries and hospitals. 0.9054054054054054 Čeprav lahko ta praksa zmanjša tveganje okužbe pri ženskah, ni dokazov o njeni učinkovitosti ob široki uporabi pri starejših bolnikih. While this practice may reduce the risk of infection in women, there is no evidence about its effectiveness when applied widely to elderly patients. 0.8865248226950354 Antimikrobiki se včasih dajejo bolnikom za preprečevanje okužb, na primer za preprečevanje okužb v zvezi s kirurškimi posegi. Antimicrobials are sometimes given to patients to prevent infections, for example to prevent infections in relation with surgical procedures. 1.0666666666666667 O razpoložljivosti smernic za uporabo antimikrobikov je poročalo 76 % bolnišnic. 76% of hospitals reported the availability of antimicrobial use guidelines. 0.8271604938271605 Tovrstno ravnanje je povezano s povečano protimikrobno odpornostjo. In addition, this practice is associated with increased antimicrobial resistance. 1.4089347079037802 V obdobju 2016-2017 je Evropski center za preprečevanje in obvladovanje bolezni (ECDC) usklajeval drugo raziskavo točkovne prevalence okužb, povezanih z zdravstveno oskrbo, in o uporabi antimikrobikov v evropskih bolnišnicah za akutno oskrbo in tretjo raziskavo točkovne prevalence o razširjenosti okužb, povezanih z zdravstveno oskrbo, ter o uporabi antimikrobikov v evropskih ustanovah za dolgotrajno oskrbo. In 2016-2017, ECDC coordinated the second point-prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals and the third point-prevalence survey of healthcare-associated infections and antimicrobial use in European long-term care facilities. 1.2222222222222223 Ključna sporočila: Uporaba antimikrobikov v zdravstvenih ustanovah Key messages: Antimicrobial use in healthcare settings 0.8910256410256411 Dolgotrajna kirurška profilaksa je pomemben primer nepotrebne rabe antimikrobikov v bolnišnicah, ki jo je treba obravnavati po vsej Evropi. Prolonged surgical prophylaxis represents a significant source of unnecessary use of antimicrobials in hospitals, which needs to be addressed across Europe. 1.4276315789473684 Čeprav so nekatere okužbe, povezane z zdravstveno oskrbo, lahko ozdravljive, lahko druge bolj resno vplivajo na bolnikovo zdravje, zaradi česar se podaljša njegovo bivanje v bolnišnici in povečajo bolnišnični stroški. Although some HAIs can be treated easily, others may more seriously affect a patient's health, increasing their stay in the hospital and hospital costs. 1.2637362637362637 Poleg tega ima samo ena od petih ustanov organizirano redno usposabljanje o ustreznem predpisovanju antimikrobikov. Moreover, only 1 in 5 LTFCs have regular training on appropriate antimicrobial prescribing. 1.0135135135135136 Eden od dveh ciklov kirurške profilakse je bil predpisan za več kot en dan. 1 in 2 surgical prophylaxis courses were prescribed for more than one day. 1.030612244897959 Antibiotiki širokega spektra niso vedno potrebni in njihova uporaba povzroča protimikrobno odpornost. Broad-spectrum antibiotics are not always necessary and their use drives antimicrobial resistance. 1.5044247787610618 Zaradi okužb, povezanih z zdravstveno oskrbo, je v bolnišnicah v Evropi več smrtnih žrtev kot zaradi katere koli druge nalezljive bolezni, katere pojavnost spremlja ECDC. HAIs in hospitals alone cause more deaths in Europe than any other infectious disease under surveillance at ECDC. 1.2601626016260163 Ocenjuje se, da se v evropskih bolnišnicah in ustanovah za dolgotrajno oskrbo, vsako leto pojavi skupno 8,9 milijona okužb, povezanih z zdravstveno oskrbo. A total of 8.9 million HAIs were estimated to occur each year in European hospitals and long-term care facilities combined. 1.12 Prehod s parenteralnega na peroralno dajanje je bil predpisan v samo 4 % receptov za parenteralne antimikrobike. Parenteral-to-oral switch was reported in only 4% of the prescriptions of parenteral antimicrobials. 0.8703703703703703 Delež receptov za antimikrobike za medicinsko profilakso lahko zato pomeni nepotrebno uporabo. A proportion of antimicrobial prescriptions for medical prophylaxis may therefore represent unnecessary use. 0.9879518072289156 Večina ciklov profilakse morda zato predstavlja nepotrebno uporabo antimikrobikov. Most prophylaxis courses may therefore represent unnecessary use of antimicrobials. 1.0327868852459017 Eden o desetih receptov za izdajo antimikrobikov je bil za medicinsko profilakso, za katero je bilo število indikacij omejeno. 1 in 10 antimicrobial prescriptions were for medical prophylaxis, for which there only is a limited number of indications. 0.9464285714285714 Običajno za kirurško profilakso zadostuje en odmerek. One dose is usually sufficient for surgical prophylaxis. 0.9836956521739131 Antimikrobiki za zdravljenje okužb rešujejo življenja, vendar lahko njihova prekomerna uporaba povzroči pogostejše neželene učinke in pojav mikroorganizmov, odpornih na več zdravil. Antimicrobial agents to treat infections are life-saving, but overuse of antimicrobials may result in more frequent adverse effects and emergence of multidrug-resistant microorganisms. 1.763157894736842 ima 98 000 bolnikov vsaj eno okužbo, povezano z zdravstveno oskrbo; 98 000 patients have at least one HAI; 1.165289256198347 Okužbe, povezane z zdravstveno oskrbo, in protimikrobna odpornost v evropskih bolnišnicah za akutno oskrbo in ustanovah za dolgotrajno oskrbo Healthcare-associated infections and antimicrobial resistance European acute care hospitals and long-term care facilities 1.1237113402061856 Sedem antimikrobikov od desetih je bilo predpisanih za zdravljenje okužbe, trije od desetih pa za profilakso. 7 in 10 antimicrobials were prescribed for treatment of an infection and 3 in 10 for prophylaxis. 0.8985507246376812 Antimikrobiki se vsesplošno predpisujejo in prispevajo k razvoju protimikrobne odpornosti v ustanovah za dolgotrajno oskrbo. Antimicrobials are commonly prescribed and contribute to the development of antimicrobial resistance in long-term care facilities (LTCFs). 1.6515151515151516 ima eden od 24 oskrbovancev v ustanovah za dolgotrajno oskrbo vsaj eno okužbo, povezano z zdravstveno oskrbo; 1 in 24 long-term care facilities residents have at least one HAI; 1.0172413793103448 Sedem od desetih antimikrobikov je bilo danih parenteralno. 7 out of 10 antimicrobials were administered parenterally. 1.0277777777777777 Eden od 20 oskrbovancev je na kateri koli dan prejel vsaj en antimikrobik. 1 in 20 residents received at least one antimicrobials on any given day. 1.0 Eden od treh bolnikov je na dnevni ravni zaužil vsaj en antimikrobik. 1 in 3 patients received at least one antimicrobial on any given day. 0.6295081967213115 pljučnica, okužbe mesta kirurškega posega in okužbe krvnega obtoka), so običajno resnejše in imajo večji vpliv kot okužbe, povezane z zdravstveno oskrbo v ustanovah za dolgotrajno oskrbo (npr. HAIs in hospitals (for example, pneumonia, surgical site infections and bloodstream infections) are usually more severe and have a higher impact than HAIs in long-term care facilities (for example, respiratory infections other than pneumonia, urinary tract infections and skin and soft tissue infections). 1.6705882352941177 Od posamezne države je odvisno, ali so v vseh njenih ustanovah za dolgotrajno oskrbo na voljo smernice za uporabo antimikrobikov ali v nobeni. Depending on the country, all or none of the LTCFs have antimicrobial use guidelines. 1.945945945945946 ima 124 000 oskrbovancev vsaj eno okužbo, povezano z zdravstveno oskrbo. 124 000 residents have least one HAI. 1.5833333333333333 ima eden od 15 bolnikov v bolnišnicah okužbo, povezano z zdravstveno oskrbo; 1 in 15 hospital patients have at least one HAI; 1.0470588235294118 V treh od štirih primerih preventivnega zdravljenja je bil namen preprečiti okužbo sečil. 3 out of 4 of the prophylaxis courses were given to prevent urinary tract infections. 1.1594202898550725 Da imajo posebno osebje za usmerjanje rabe antimikrobikov, jih je poročalo 54 %. 54% reported some dedicated staff time for antimicrobial stewardship. 1.0384615384615385 Katera so ključna sporočila in kako se bodo uporabila? What are the key messages and how they will be used? 1.2222222222222223 Kaj pomeni „strokovno usklajeno"? What is "expert consensus"? 0.9206349206349206 Ključna sporočila so temelj vsake komunikacijske kampanje. Key messages are the cornerstone of any communication campaign. 0.8918918918918919 Ključna sporočila v novem orodju: The key messages for the new toolkit: 1.093198992443325 veljajo za številne zdravstvene delavce, zaposlene v bolnišnicah in drugih zdravstvenih ustanovah: vodstvo/upravno osebje, infektologe, strokovnjake za preprečevanje in obvladovanje okužb, epidemiologe, zdravnike, ki predpisujejo zdravila, zdravnike specializante in študente, farmacevte, negovalno osebje, klinične mikrobiologe ter strokovnjake na urgentnih oddelkih, oddelkih za intenzivno nego in v ustanovah za dolgotrajno oskrbo. Cover a number of professionals working at hospitals and other healthcare settings: managers/administrators, infectious disease specialists, infection prevention and control professionals, epidemiologists, prescribers, junior doctors and students, pharmacists, nurses, clinical microbiologists, and professionals in emergency departments, in intensive care units, and in long-term care facilities. 0.9695945945945946 Kadar je v tem dokumentu sklic na sporočilo označen kot „strokovno usklajeno", se ECDC sklicuje na sporazum, sprejet v okviru opisanega postopka odločanja, vključno z notranjim soglasjem strokovnjakov ECDC, mnenjem članov EAAD TAC ter posvetovanjem z zunanjimi strokovnjaki in deležniki. When, in this document, a reference to a message is indicated as "expert consensus", ECDC is referring to the agreement reached in the outlined decision-making process, including ECDC experts' internal agreement, EAAD TAC members' opinion, and consultation with external experts and stakeholders. 0.9299610894941635 Pomembno je poudariti, da predlogi ECDC vsebujejo bistvene informacije in skupna sporočila, vendar bodo najučinkovitejša, če se prilagodijo potrebam in razmeram v posamezni državi, pa tudi posamezni bolnišnici oziroma zdravstveni ustanovi. It is important to stress that the template materials developed by ECDC provide core information and common messages, but will be most effective if adapted to respond to the needs and situations in each country, and even each hospital or healthcare setting. 1.0898876404494382 Države bi morale razmisliti o povečanju razpoložljivih nacionalnih podatkov o odpornosti in porabi antibiotikov, ki so na voljo v okviru mreže EARS-Net oziroma ESAC-Net, ter se z nacionalnimi strokovnimi združenji posvetovati o tem, katera orodja so najprimernejša za uporabo v svoji državi. Countries could consider leveraging the national antibiotic resistance and antibiotic consumption data available from EARS-Net and ESAC-Net respectively, and consulting with national professional associations on the most appropriate tools to be used in their country. 1.0746268656716418 so namenjena ustvarjanju občutka osebne odgovornosti na področju odpornosti proti antibiotikom in spodbujanju zdravstvenih delavcev k ukrepanju; Aim at creating a sense of individual responsibility in tackling antibiotic resistance and at empowering professionals to take action. 1.0187793427230047 ECDC je za podporo obveščanja na nacionalni ravni pripravil številna komunikacijska orodja, ki vsebujejo predloge in na dokazih temelječa ključna sporočila, ki jih je mogoče prilagoditi za uporabo na nacionalni ravni. To support communication activities at national level, ECDC has produced several communication toolkits containing template materials and evidence-based key messages which may be adapted for use at national level. 0.7295597484276729 zagotavljajo sklop trdnih izjav, dopolnjenih z viri, ki se lahko uporabijo kot vsebinska podlaga za predloge gradiv; Provide a set of water-tight statements, each of which is accompanied by a reference, that should be used as a basis for the content of the template materials; 0.9421487603305785 Vsako leto ga v Evropi obeležujemo 18. novembra z organizacijo nacionalnih kampanj za preudarno rabo antibiotikov. Each year across Europe, EAAD is marked by national campaigns on the prudent use of antibiotics on or around 18 November. 0.8061224489795918 Evropski dan ozaveščanja o antibiotikih (EAAD) je evropska pobuda za zdravje, ki jo usklajuje Evropski center za preprečevanje in obvladovanje bolezni (ECDC). European Antibiotic Awareness Day (EAAD) is a European health initiative coordinated by ECDC, which aims to provide a platform and support for national campaigns on the prudent use of antibiotics. 1.2531645569620253 V posameznih državah EU/EGP se pojavljajo različne težave v zvezi z odpornostjo proti antibiotikom. The issues surrounding antibiotic resistance may differ in each EU/EEA country. 0.9310344827586207 če ste starejši kot 65 let; if you are over 65 years old; 0.7684210526315789 Najti primeren čas za obisk zdravnika je lahko težavno, drago in zamudno. Finding an appropriate time to visit the doctor can be difficult, expensive and time-consuming. 0.9032258064516129 če imate astmo ali diabetes; if you have asthma or diabetes; 0.5714285714285714 Pomoč poiščite čim prej: Seek help more quickly than other people : 1.380281690140845 Pri večini bolezni, ki se pojavljajo predvsem pozimi, se bo vaše stanje izboljšalo po dveh tednih. For most winter illnesses, your condition will improve after two weeks. 1.1367521367521367 Če boste torej vi, vaši otroci ali drugi družinski člani v prihodnosti potrebovali antibiotike, ti mogoče ne bodo več učinkoviti [7]. So if at some point in time you, your children or other family members need antibiotics, they may no longer work [7]. 1.504950495049505 Seznam je povzet po projektu „Genomics to combat resistance against antibiotics in community-acquired LRTI in Europe (Genomika za boj proti odpornosti na antibiotike pri zunajbolnišničnih okužbah spodnjih dihal v Evropi)", ki ga financira Generalni direktorat Evropske komisije za raziskave in inovacije. List adapted from ‘Genomics to combat resistance against antibiotics in community-acquired LRTI in Europe', a project funded by the European Commission's Directorate-General for Research and Innovation. 0.84 Antibiotike vam lahko predpiše le zdravnik, ki vas je pregledal Antibiotics can only be prescribed by a medical doctor who has examined you 0.7333333333333333 Naučite se poskrbeti zase brez antibiotikov. Learn how you can take care of yourself without antibiotics. 0.9893617021276596 Če simptomi vztrajajo ali če imate kakršne koli pomisleke, se posvetujte s svojim zdravnikom. If your symptoms persist or if you have any concern, it is important that you see your doctor. 0.972972972972973 Bakterije, odporne proti antibiotikom, so nevarne vsem nam, saj povzročajo okužbe, ki jih je težko zdraviti. Antibiotic-resistant bacteria are a danger to us all because they cause infections that are difficult to treat. 1.4845360824742269 Veliko bolezni, ki se pojavljajo predvsem pozimi, lahko povzroči enake simptome, vendar to še ne pomeni, da te zahtevajo tudi enako zdravljenje. Many winter illnesses can cause the same symptoms, but they might not require the same treatment. 0.9622641509433962 Če pa dejansko imate hudo okužbo, kot je bakterijska pljučnica, vam bo zdravnik predpisal antibiotike. If you really have a severe infection such as bacterial pneumonia, your doctor will prescribe antibiotics. 1.2222222222222223 Samozdravljenje pomeni, da antibiotike jemljete (ali želite jemati) ne da bi se pred tem posvetovali z zdravnikom, in sicer tako da: Self-medication is when you take (or want to take) antibiotics without first consulting a medical doctor by: 1.0828402366863905 Če antibiotike jemljemo pogosto in neustrezno, s tem prispevamo k povečanju števila proti antibiotikom odpornih bakterij, kar je ena najbolj perečih zdravstvenih težav na svetu [1-6]. If we take antibiotics repeatedly and improperly, we contribute to the increase in antibiotic-resistant bacteria, one of the world's most pressing health problems [1-6]. 0.7411764705882353 Z besedo „antibiotiki" ECDC označuje protibakterijska zdravila. Note: With the word "antibiotics", ECDC means antibacterial agents or antibacterials. 1.3194444444444444 če imate zdravstveno težavo, zaradi katere je delovanje vašega imunskega sistema oslabljeno ali if you have a medical problem where your immune system is suppressed; or 1.1538461538461537 Do 80 % bolezni, ki se pojavljajo predvsem pozimi in prizadenejo vaš nos, ušesa, grlo ali pljuča, je virusnega izvora, zato se zaradi antibiotikov ne boste počutili bolje [11, 12]. Up to 80% of winter illnesses affecting your nose, ears, throat and lungs are of viral origin, so taking antibiotics will not make you feel better [11, 12]. 1.0 Jemanje antibiotikov ne bo zmanjšalo resnosti simptomov in ne bo pripomoglo k vašemu hitrejšemu okrevanju [10, 12, 15, 17]. Taking antibiotics will not reduce the severity of your symptoms and will not help you feel better faster [10, 12, 15, 17]. 0.9344262295081968 Vendar pa lahko le zdravnik, ki vas je pregledal, presodi, ali določena bolezen zahteva zdravljenje z antibiotiki. However, only a medical doctor who has examined you can ascertain if a winter illness requires treatment with antibiotics. 0.8832116788321168 Izpolnjevanje vsakodnevnih obveznosti med boleznijo je lahko stresno, zlasti če se z določenimi simptomi spopadate prvič. Meeting life's demands while being ill can be a source of stress, especially if you are experiencing certain symptoms for the first time. 0.9375 Večino simptomov je mogoče olajšati z zdravili brez recepta. Most symptoms can be alleviated with over-the-counter medicines. 0.987012987012987 Samozdravljenje z antibiotiki je neodgovoren način uporabe antibiotikov [8]. Self-medication with antibiotics is not a responsible use of antibiotics [8]. 1.4507042253521127 Okvirno trajanje znakov/simptomov pri pogostih boleznih, ki se pojavljajo predvsem pozimi, pri odraslih Indicative duratio​​n of symptoms for common winter illnesses in adults 1.2950819672131149 Antibiotiki niso protibolečinska zdravila in ne morejo pozdraviti vsake bolezni Antibiotics are not painkillers and cannot cure every illness 1.0600858369098713 Jemanje antibiotikov v primeru blagih bakterijskih okužb, kot so rinosinuzitis, boleče grlo, bronhitis ali bolečine v ušesih, je pogosto nepotrebno [15-19], saj se lahko naš imunski sistem v večini primerov sam spopade s takšnimi blagimi okužbami. Taking antibiotics to fight mild bacterial infections, such as rhinosinusitis, sore throats, bronchitis or earaches, is often unnecessary [15-19] since, in most cases, your own immune system is able to deal with such mild infections. 1.0710059171597632 Če vam je zdravnik za določeno bolezen v preteklosti predpisal antibiotik in je bilo zdravljenje uspešno, boste mogoče ob pojavu podobnih simptomov želeli uporabiti isti antibiotik. If you have been prescribed an antibiotic for a previous illness and have recovered well, it is tempting to want to use the same antibiotic if you have similar symptoms. 0.711864406779661 kupite antibiotike v lekarni brez recepta. getting antibiotics at the pharmacy without a prescription. 0.926829268292683 Poleg tega lahko povzročijo številne neprijetne učinke, kot so driska, slabost ali kožni izpuščaji [9, 10, 13-15]. In addition, antibiotics may cause several unpleasant side effects such as diarrhoea, nausea or skin rashes [9, 10, 13-15]. 1.0681818181818181 Jemanje antibiotikov proti prehladu ali gripi vam nikakor ne bo koristilo: antibiotiki enostavno ne učinkujejo proti virusnim okužbam [9-12]. Taking antibiotics against a cold or the flu has no benefit for you: antibiotics simply do not work against viral infections [9-12]. 1.1654135338345866 Jemanje antibiotikov iz napačnih razlogov, na primer proti prehladu ali gripi, ne bo pripomoglo k hitrejšemu okrevanju in utegne povzročiti neželene učinke Taking antibiotics for wrong reasons, such as against colds and flu, will not help you feel better faster, and may cause side-effects 1.2911392405063291 Če boste vedeli, kako obvladati znake/simptome bolezni, se boste lahko z boleznijo uspešneje spopadli. Knowing how to manage your symptoms can help you cope better with your illness. 1.0384615384615385 Nikoli ne poskušajte kupiti antibiotikov brez recepta. Never try to buy antibiotics without a prescription. 1.0357142857142858 uporabite ostanke antibiotikov iz preteklih zdravljenj ali using leftover antibiotics from previous treatments; or, 0.7872340425531915 Ne hranite ostankov antibiotikov [8]. Do not keep leftover antibiotic treatments [8]. 0.6732673267326733 kronični bronhitis, emfizem, kronično obstruktivno pljučno bolezen); if you have lung disease (e.g. chronic bronchitis, emphysema, chronic obstructive pulmonary disease); 1.2127659574468086 Antibiotiki ne delujejo kot protibolečinska zdravila in ne morejo ublažiti glavobolov, drugih bolečin ali vročine. Antibiotics do not work like painkillers and cannot relieve headaches, aches, pains or fevers. 0.7678571428571429 Antibiotiki učinkujejo le proti bakterijskim okužbam in ne morejo ozdraviti virusnih okužb, kot sta prehlad ali gripa [9-12, 14]. Antibiotics are only effective against bacterial infections and cannot help you recover from infections caused by viruses such as the common cold or the flu [9-12, 14]. 0.8390804597701149 srčni infarkt v preteklosti, angino pektoris, kronično srčno popuščanje); if you have heart problems (e.g. previous heart attack, angina, chronic heart failure); 1.3783783783783783 Nikoli ne hranite antibiotikov za poznejšo uporabo. Never save antibiotics for later use. 1.0980392156862746 Nikoli ne delite ostankov antibiotikov z drugimi ljudmi. Never share leftover antibiotics with other people. 0.6733333333333333 steroide, kemoterapijo za zdravljenje raka, nekatera zdravila za zaviranje delovanja žleze ščitnice). if you are taking drugs that suppress the immune system (e.g. steroids, chemotherapy for cancer, some drugs used to suppress thyroid gland functions). 1.1785714285714286 Nikoli ne uporabite ostankov antibiotikov iz preteklih zdravljenj. Never use leftover antibiotics from previous treatments. 0.803921568627451 tablet, želatinskih kapsul) kot vam jih je bilo predpisanih, se o odstranjevanju ostankov zdravil posvetujte s farmacevtom. If you received more antibiotic doses (e.g. tablets, gel caps) than you were prescribed, ask your pharmacist about how to dispose of the remaining doses. 2.8 Kaj je težava? Jama. 1.4343434343434343 Zaradi nepravilne rabe antibiotikov se lahko v bolnikih naselijo ali se okužijo z bakterijami, odpornimi na antibiotike, kot so na primer na meticilin odporna bakterija Staphylococcus aureus (MRSA), na vankomicin odporni enterococci (VRE) in močno odporni Gram negativni bacili (2-3). The commonality of risk factors for nosocomial colonization and infection with antimicrobial-resistant Staphylococcus aureus, enterococcus, gram-negative bacilli, Clostridium difficile, and Candida. 0.9743589743589743 Nepravilna raba antibiotikov je eden od glavnih vzrokov za razvoj odpornosti na antibiotike v bolnišnicah (15-17); Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. 0.7 Uporabi Media type