{"id":53054,"date":"2024-11-11T14:06:17","date_gmt":"2024-11-11T13:06:17","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=53054"},"modified":"2024-11-11T14:06:27","modified_gmt":"2024-11-11T13:06:27","slug":"do-30-let-mohou-infekce-zabijet-casteji-nez-rakovina","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=53054","title":{"rendered":"Do 30 let mohou infekce zab\u00edjet \u010dast\u011bji ne\u017e rakovina"},"content":{"rendered":"\n

L\u00e9ka\u0159i varuj\u00ed p\u0159ed nevhodn\u00fdm u\u017e\u00edv\u00e1n\u00edm antibiotik<\/em><\/p>\n\n\n\n

Praha, 11. 11. 2024 \u2013 Ve sv\u011bt\u011b nar\u016fst\u00e1 mno\u017estv\u00ed bakteri\u00ed odoln\u00fdch v\u016f\u010di antibiotik\u016fm. Podle l\u00e9ka\u0159\u016f za to m\u016f\u017ee mimo jin\u00e9 nespr\u00e1vn\u00e9 u\u017e\u00edv\u00e1n\u00ed l\u00e9k\u016f. Pokud se situace nezm\u011bn\u00ed, <\/strong>podle v\u011bdeck\u00fdch odhad\u016f<\/a> <\/strong>hroz\u00ed, \u017ee do roku 2050 bude na infek\u010dn\u00ed onemocn\u011bn\u00ed celosv\u011btov\u011b um\u00edrat v\u00edce lid\u00ed ne\u017e na rakovinu \u2013 ro\u010dn\u011b a\u017e 10 milion\u016f osob. Nejen o t\u011bchto faktech a hrozb\u00e1ch diskutovali minul\u00fd v\u00edkend v Karlov\u00fdch Varech odborn\u00edci na XLIII. v\u00fdro\u010dn\u00ed konferenci Spole\u010dnosti v\u0161eobecn\u00e9ho l\u00e9ka\u0159stv\u00ed (SVL) \u010cLS JEP.<\/strong><\/p>\n\n\n\n

\u201eBohu\u017eel n\u011bkte\u0159\u00ed l\u00e9ka\u0159i u ban\u00e1ln\u00edch onemocn\u011bn\u00ed sahaj\u00ed po antibiotic\u00edch se \u0161irok\u00fdm spektrem \u00fa\u010dinku. Tyto l\u00e9ky ale p\u0159isp\u00edvaj\u00ed ke vzniku bakteri\u00e1ln\u00ed rezistence, tedy odolnosti bakteri\u00ed v\u016f\u010di n\u011bkter\u00fdm typ\u016fm antibiotik. Tento probl\u00e9m nen\u00ed zdaleka tak patrn\u00fd v sektoru prim\u00e1rn\u00ed p\u00e9\u010de jako v nemocnic\u00edch. Zde se mohou vyskytnout tzv. nozokomi\u00e1ln\u00ed infekce, kter\u00e9 jsou z\u00e1va\u017enou komplikac\u00ed pro hospitalizovan\u00e9 pacienty. L\u00e9\u010dba t\u011bchto infekc\u00ed b\u00fdv\u00e1 \u010dasto velmi n\u00e1ro\u010dn\u00e1, nebo\u0165 jejich p\u016fvodci jsou na b\u011b\u017en\u00e1 antibiotika mnohdy rezistentn\u00ed,\u201c <\/em>\u0159\u00edk\u00e1 MUDr. Igor Karen, v\u0161eobecn\u00fd praktick\u00fd l\u00e9ka\u0159, infektolog a m\u00edstop\u0159edseda pro profesn\u00ed z\u00e1le\u017eitosti SVL \u010cLS JEP.<\/p>\n\n\n\n

Podle MUDr. Ludmily Bezd\u00ed\u010dkov\u00e9, praktick\u00e9 l\u00e9ka\u0159ky a \u010dlenky v\u00fdboru SVL \u010cLS JEP, je odolnost v\u016f\u010di antibiotik\u016fm glob\u00e1ln\u00ed hrozbou. \u201eSv\u011btov\u00e1 zdravotnick\u00e1 organizace odhaduje, \u017ee do 30 let m\u016f\u017ee na infekce um\u00edrat v\u00edce lid\u00ed ne\u017e na onkologick\u00e1 onemocn\u011bn\u00ed. V \u010cesk\u00e9 republice bychom pot\u0159ebovali zlep\u0161it zejm\u00e9na kvalitu p\u0159edepisovan\u00fdch antibiotik, volit ta s co neju\u017e\u0161\u00edm spektrem \u00fa\u010dinku,\u201c <\/em>\u0159\u00edk\u00e1 MUDr. Bezd\u00ed\u010dkov\u00e1. Pr\u00e1v\u011b nadu\u017e\u00edv\u00e1n\u00ed takzvan\u00fdch \u0161irokospektr\u00fdch antibiotik je podle l\u00e9ka\u0159ky aktu\u00e1ln\u011b nejv\u011bt\u0161\u00edm probl\u00e9mem. \u201eV Evrop\u011b jsme na \u010deln\u00edch p\u0159\u00ed\u010dk\u00e1ch v p\u0159edepisov\u00e1n\u00ed takzvan\u00fdch makrolid\u016f \u2013 to jsou antibiotika, kter\u00e1 maj\u00ed potenci\u00e1l vyvolat bakteri\u00e1ln\u00ed rezistenci,\u201c<\/em> popisuje.<\/p>\n\n\n\n

Na konferenci SVL proto l\u00e9ka\u0159i diskutovali zbrusu nov\u00fd Doporu\u010den\u00fd postup racion\u00e1ln\u00ed antibiotick\u00e9 terapie. \u201ePod\u00edl\u00ed se na n\u011bm \u0159ada odborn\u00fdch spole\u010dnost\u00ed \u2013 pneumologick\u00e1, urologick\u00e1, dermatovenerologick\u00e1, mikrobiologick\u00e1, infektologick\u00e1 a na\u0161e. Snahou je, aby tento text vznikl jako mezioborov\u00fd konsenzus a odr\u00e1\u017eel nov\u00e9 pohledy na racion\u00e1ln\u00ed antibiotickou terapii zejm\u00e9na v\u00a0ter\u00e9nu,\u201c <\/em>dopl\u0148uje MUDr. Karen, hlavn\u00ed koordin\u00e1tor a odborn\u00fd garant doporu\u010den\u00e9ho postupu. <\/p>\n\n\n\n

Odborn\u00edci se v\u00a0posledn\u00edch letech intenzivn\u011b zam\u011b\u0159ili na vzd\u011bl\u00e1v\u00e1n\u00ed ambulantn\u00edch specialist\u016f \u2013 praktik\u016f, pediatr\u016f, dermatolog\u016f, urolog\u016f a l\u00e9ka\u0159\u016f dal\u0161\u00edch specializac\u00ed. Vznikly doporu\u010den\u00e9 postupy pro l\u00e9\u010dbu jednotliv\u00fdch druh\u016f infekc\u00ed. \u201eJak praktici, tak ambulantn\u00ed specialist\u00e9 mus\u00ed m\u00edt k\u00a0dispozici dostate\u010dn\u00e9 portfolio antibiotik, aby mohli co nejl\u00e9pe zac\u00edlit l\u00e9ky a dos\u00e1hli antibakteri\u00e1ln\u00edho efektu v\u00a0co nejkrat\u0161\u00ed dob\u011b. Pokud nap\u0159\u00edklad dojde k\u00a0dlouhodob\u00e9mu v\u00fdpadku antibiotik, hroz\u00ed riziko vzniku rezistence i u b\u011b\u017en\u00fdch komunitn\u00edch patogen\u016f,\u201c<\/em> uv\u00e1d\u00ed prim. MUDr. Michaela Matou\u0161kov\u00e1 za \u010ceskou urologickou spole\u010dnost \u010cLS JEP.<\/p>\n\n\n\n

Dlouhodob\u00fdm probl\u00e9mem z\u016fst\u00e1v\u00e1 p\u0159edepisov\u00e1n\u00ed antibiotik v\u00a0p\u0159\u00edpadech, kdy za infekc\u00ed nestoj\u00ed bakterie. \u201eV p\u0159\u00edpad\u011b vir\u016f antibiotika nepomohou,\u201c<\/em> upozor\u0148uje MUDr. Bezd\u00ed\u010dkov\u00e1. L\u00e9ka\u0159i dnes maj\u00ed k\u00a0dispozici celou \u0159adu diagnostick\u00fdch metod, s\u00a0jejich\u017e pomoc\u00ed lze ur\u010dit p\u016fvodce onemocn\u011bn\u00ed. \u201eUm\u00edme stanovit hladinu z\u00e1n\u011btliv\u00fdch parametr\u016f, nej\u010dast\u011bji vy\u0161et\u0159en\u00edm C-reaktivn\u00edho proteinu (CRP), ale i krevn\u00edho obrazu. CRP m\u016f\u017ee b\u00fdt ale v\u00fdznamn\u011b vy\u0161\u0161\u00ed i u n\u011bkter\u00fdch virov\u00fdch onemocn\u011bn\u00ed, typicky u ch\u0159ipky nebo covidu-19. Proto je v\u017edy t\u0159eba v\u00fdsledky spr\u00e1vn\u011b interpretovat. V\u00a0mnoha situac\u00edch nen\u00ed t\u0159eba v\u00a0po\u010d\u00e1tku onemocn\u011bn\u00ed pacienta testovat, proto\u017ee pravd\u011bpodobnost virov\u00e9 infekce je velmi vysok\u00e1, a takov\u00fd pacient si vysta\u010d\u00ed s\u00a0dom\u00e1c\u00ed l\u00e9\u010dbou. U rizikov\u00fdch osob, kde m\u00e1me k\u00a0dispozici specifickou l\u00e9\u010dbu, nap\u0159. antivirotika u covidu-19 i pro n\u011bkter\u00e1 virov\u00e1 onemocn\u011bn\u00ed, naopak \u010dast\u011bji d\u0159\u00edve vy\u0161et\u0159ujeme,\u201c <\/em>vysv\u011btluje MUDr. Bezd\u00ed\u010dkov\u00e1.<\/p>\n\n\n\n

L\u00e9ka\u0159i mohou tak\u00e9 vyu\u017e\u00edt rychl\u00e9 antigenn\u00ed testy, kter\u00e9 potvrd\u00ed \u010di vylou\u010d\u00ed bakteri\u00e1ln\u00ed p\u016fvod. \u201eNebo naopak provedeme test na streptokokov\u00fd antigen, kter\u00fd uk\u00e1\u017ee na streptokokovou tonzilitidu, tedy typickou bakteri\u00e1ln\u00ed ang\u00ednu, kterou pak m\u016f\u017eeme zal\u00e9\u010dit specifick\u00fdm antibiotikem,\u201c<\/em> \u0159\u00edk\u00e1 MUDr. Karen. P\u0159i stanoven\u00ed diagn\u00f3zy je podle l\u00e9ka\u0159\u016f pot\u0159eba br\u00e1t v\u00a0\u00favahu tak\u00e9 to, jak\u00e9 infekce se v\u00a0danou chv\u00edli v\u00a0populaci vyskytuj\u00ed.<\/p>\n\n\n\n

\u201eZapom\u00ednat bychom nem\u011bli ani na celkov\u00fd charakter pacienta \u2013 zda netrp\u00ed n\u011bjak\u00fdm chronick\u00fdm onemocn\u011bn\u00edm nebo zda nebyl hospitalizov\u00e1n v\u00a0nemocnici, kde je riziko n\u00e1kazy vy\u0161\u0161\u00ed,\u201c<\/em> up\u0159es\u0148uje MUDr. Bezd\u00ed\u010dkov\u00e1. A zde podle l\u00e9ka\u0159ky hraj\u00ed d\u016fle\u017eitou \u00falohu praktici. \u201eM\u011bli bychom zv\u00fd\u0161it kvalitu antibiotick\u00e9 preskripce, sna\u017eit se zal\u00e9\u010dit maximum infekc\u00ed v\u00a0dom\u00e1c\u00edm prost\u0159ed\u00ed, aby se pacienti nedost\u00e1vali zbyte\u010dn\u011b do nemocnic. Z\u00e1rove\u0148 omezit p\u0159edepisov\u00e1n\u00ed antibiotik v\u00a0situac\u00edch, kdy jsou infekce s\u00a0velkou pravd\u011bpodobnost\u00ed virov\u00e9 a antibiotika nejsou v\u016fbec pot\u0159eba,\u201c<\/em> shrnuje praktick\u00e1 l\u00e9ka\u0159ka.<\/p>\n\n\n\n

Nad\u011bj\u00ed do budoucna mohou b\u00fdt l\u00e9ky nov\u00e9 generace. \u201eObjev nov\u00e9 substance je v\u017edy velmi n\u00e1ro\u010dn\u00fd a drah\u00fd proces. Pokud se nov\u00e9 antibiotikum poda\u0159\u00ed vyvinout, nen\u00ed dostupn\u00e9 automaticky v\u0161em. Naopak, s trochu nads\u00e1zky je mo\u017en\u00e9 \u0159\u00edct, \u017ee z\u016fst\u00e1v\u00e1 zam\u010deno v trezoru a pou\u017e\u00edv\u00e1 se jen ve velmi ojedin\u011bl\u00fdch p\u0159\u00edpadech na skute\u010dn\u011b rezistentn\u00ed infekce. Jedin\u011b tak si l\u00e9k zachov\u00e1 svoji \u00fa\u010dinnost,\u201c<\/em> popisuje MUDr. Karen. Tato antibiotika z\u016fst\u00e1vaj\u00ed v rukou mikrobiolog\u016f \u010di infektolog\u016f, kte\u0159\u00ed hl\u00eddaj\u00ed jejich nasazen\u00ed.<\/p>\n\n\n\n

<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

L\u00e9ka\u0159i varuj\u00ed p\u0159ed nevhodn\u00fdm u\u017e\u00edv\u00e1n\u00edm antibiotik Praha, 11. 11. 2024 \u2013 Ve sv\u011bt\u011b nar\u016fst\u00e1 mno\u017estv\u00ed bakteri\u00ed odoln\u00fdch v\u016f\u010di antibiotik\u016fm. Podle l\u00e9ka\u0159\u016f za to m\u016f\u017ee mimo […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14126,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-53054","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/53054","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=53054"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/53054\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14126"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=53054"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=53054"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=53054"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}