脓毒症的经验性抗感染治疗

被引:6
作者
周发春
罗娜
郭睿
机构
[1] 重庆医科大学附属第一医院重症医学科
关键词
脓毒症; 抗生素; 治疗;
D O I
暂无
中图分类号
R459.7 [急症、急救处理];
学科分类号
100231 [临床病理学];
摘要
严重脓毒症和脓毒性休克在重症患者中的死亡率较高。早期、合理的经验性抗感染治疗是提高患者生存的基石。然而随着耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)及产超广谱β-内酰胺酶(extend-ed-spectrum beta-lactamases,ESBLs)菌等多重耐药菌株(multidrug-resistant organism,MDRO)的日益增多以及抗菌药物种类的限制,使经验性抗生素选择面临巨大挑战。本文将对近年来国内外脓毒症经验性抗菌药物选择方面的研究做一综述,以期为临床决策的制定提供参考。
引用
收藏
页码:23 / 27
页数:5
相关论文
共 10 条
[1]
抗生素轮换和替换(干预)与控制细菌耐药.[J].赵宗珉;陈佰义;.中华内科杂志.2007, 07
[2]
Overview of antimicrobial therapy in intensive care units [J].
Textoris, Julien ;
Wiramus, Sandrine ;
Martin, Claude ;
Leone, Marc .
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY, 2011, 9 (01) :97-109
[3]
Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: A propensity-matched analysis [J].
Kumar, Anand ;
Zarychanski, Ryan ;
Light, Bruce ;
Parrillo, Joseph ;
Maki, Dennis ;
Simon, Dave ;
Laporta, Denny ;
Lapinsky, Steve ;
Ellis, Paul ;
Mirzanejad, Yazdan ;
Martinka, Greg ;
Keenan, Sean ;
Wood, Gordon ;
Arabi, Yaseen ;
Feinstein, Daniel ;
Kumar, Aseem ;
Dodek, Peter ;
Kravetsky, Laura ;
Doucette, Steve .
CRITICAL CARE MEDICINE, 2010, 38 (09) :1773-1785
[4]
The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis.[J].Mitchell M. Levy;R. Phillip Dellinger;Sean R. Townsend;Walter T. Linde-Zwirble;John C. Marshall;Julian Bion;Christa Schorr;Antonio Artigas;Graham Ramsay;Richard Beale;Margaret M. Parker;Herwig Gerlach;Konrad Reinhart;Eliezer Silva;Maurene Harvey;Susan Regan;Derek C. Angus.Intensive Care Medicine.2010, 2
[5]
Rotation of antimicrobial therapy in the intensive care unit: impact on incidence of ventilator-associated pneumonia caused by antibiotic-resistant Gram-negative bacteria [J].
Raineri, E. ;
Crema, L. ;
Dal Zoppo, S. ;
Acquarolo, A. ;
Pan, A. ;
Carnevale, G. ;
Albertario, F. ;
Candiani, A. .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2010, 29 (08) :1015-1024
[6]
Initiation of Inappropriate Antimicrobial Therapy Results in a Fivefold Reduction of Survival in Human Septic Shock [J].
Kumar, Anand ;
Ellis, Paul ;
Arabi, Yaseen ;
Roberts, Dan ;
Light, Bruce ;
Parrillo, Joseph E. ;
Dodek, Peter ;
Wood, Gordon ;
Kumar, Aseem ;
Simon, David ;
Peters, Cheryl ;
Ahsan, Muhammad ;
Chateau, Dan .
CHEST, 2009, 136 (05) :1237-1248
[7]
Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008 [J].
Dellinger, R. Phillip ;
Levy, Mitchell M. ;
Carlet, Jean M. ;
Bion, Julian ;
Parker, Margaret M. ;
Jaeschke, Roman ;
Reinhart, Konrad ;
Angus, Derek C. ;
Brun-Buisson, Christian ;
Beale, Richard ;
Calandra, Thierry ;
Dhainaut, Jean-Francois ;
Gerlach, Herwig ;
Harvey, Maurene ;
Marini, John J. ;
Marshall, John ;
Ranieri, Marco ;
Ramsay, Graham ;
Sevransky, Jonathan ;
Thompson, B. Taylor ;
Townsend, Sean ;
Vender, Jeffrey S. ;
Zimmerman, Janice L. ;
Vincent, Jean-Louis .
INTENSIVE CARE MEDICINE, 2008, 34 (01) :17-60
[8]
Using local microbiologic data to develop institution-specific guidelines for the treatment of hospital-acquired pneumonia [J].
Beardsley, James R. ;
Williamson, John C. ;
Johnson, James W. ;
Ohl, Christopher A. ;
Karchmer, Tobi B. ;
Bowton, David L. .
CHEST, 2006, 130 (03) :787-793
[9]
Comparison of antimicrobial cycling and mixing strategies in two medical intensive care units [J].
Martínez, JA ;
Nicolás, JM ;
Marco, F ;
Horcajada, JP ;
Garcia-Segarra, G ;
Trilla, A ;
Codina, C ;
Torres, A ;
Mensa, J .
CRITICAL CARE MEDICINE, 2006, 34 (02) :329-336
[10]
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock [J].
Kumar, Arland ;
Roberts, Daniel ;
Wood, Kenneth E. ;
Light, Bruce ;
Parrillo, Joseph E. ;
Sharma, Satendra ;
Suppes, Robert ;
Feinstein, Daniel ;
Zanotti, Sergio ;
Taiberg, Leo ;
Gurka, David ;
Kumar, Aseem ;
Cheang, Mary .
CRITICAL CARE MEDICINE, 2006, 34 (06) :1589-1596