1、抗感染药物发展简史1929 Alexander Fleming 发现青霉素1939 Howard Florey 和 Ernst Chain分离获得青霉素，用于动物试验。1942 青霉素首次用于救治战伤患者，拯救了 许多人的生命1950s 大量抗生素用于临床。A poster from World War II, dramatically showing the virtues of the new miracle drug, and representing the high level of motivation in the country to aid the health of the
2、 soldiers at war.Discovery of Antibacterial AgentsCycloserineErythromycinEthionamideIsoniazidMetronidazolePyrazinamideRifamycinTrimethoprimVancomycinVirginiamycinImipenem1930 1940 1950 1960 1970 1980 1990 2000PenicillinProntosilCephalosporin CEthambutolFusidic acidMupirocinNalidixic acidOxazolidinon
3、esCecropinFluoroquinolonesNewer aminoglycosidesSemi-synthetic penicillins 119;405-411Control of Antibiotic ResistanceAntibiotic Stewardship in Fighting ResistanceTypes of stewardship11.Cycling/rotation12.Therapeutic substitution 13.Formulary intervention（restriction/add-on）1.General education2.Guide
4、lines3.Clinical pathway4.Expert approval of restricted drugs 5.Review/recommend changes to Abx therapy6.Therapeutic drug monitoring()7.Audit and feedback (TDM)8.Compulsory order forms for restricted drugs 9.Compulsory interactive computer order form10.Automatic antibiotic stop-order policy抗菌药物临床 用抗菌药物临床理
