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在重症监护病房轮换使用抗生素：可行，看似有益，但问题依然存在。

Rotating antibiotics in the intensive care unit: feasible, apparently beneficial, but questions remain.

作者信息

Pechère Jean-Claude

机构信息

Department of Genetics and Microbiology, University of Geneva, Switzerland.

出版信息

Crit Care. 2002 Feb;6(1):9-10. doi: 10.1186/cc1445. Epub 2002 Jan 11.

DOI:10.1186/cc1445
PMID:11940258
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC137389/
Abstract

Rotating antibiotics in the intensive care unit may result in less infections caused by resistant organisms and in even less mortality. The selection of super-resistant organisms associated with the rotation strategy cannot be excluded, however, and many practical issues will have to be addressed before antibiotic rotation can be routinely recommended.

摘要

在重症监护病房轮换使用抗生素可能会减少由耐药菌引起的感染，并降低死亡率。然而，不能排除与轮换策略相关的超级耐药菌的出现，而且在抗生素轮换能够被常规推荐之前，还有许多实际问题需要解决。

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本文引用的文献

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Antibiotic resistance in gram-negative bacteria: the role of gene cassettes and integrons.革兰氏阴性菌中的抗生素耐药性：基因盒与整合子的作用
Drug Resist Updat. 1998;1(2):109-19. doi: 10.1016/s1368-7646(98)80026-5.
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Impact of a rotating empiric antibiotic schedule on infectious mortality in an intensive care unit.轮换经验性抗生素方案对重症监护病房感染性死亡率的影响。
Crit Care Med. 2001 Jun;29(6):1101-8. doi: 10.1097/00003246-200106000-00001.
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Bacterial antibiotic efflux systems of medical importance.具有医学重要性的细菌抗生素外排系统。
Cell Mol Life Sci. 1999 Nov 30;56(9-10):771-8. doi: 10.1007/s000180050024.
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Rotation and restricted use of antibiotics in a medical intensive care unit. Impact on the incidence of ventilator-associated pneumonia caused by antibiotic-resistant gram-negative bacteria.医学重症监护病房中抗生素的轮换与限制使用。对耐抗生素革兰氏阴性菌所致呼吸机相关性肺炎发病率的影响。
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The microbial genetics of antibiotic cycling.抗生素循环使用的微生物遗传学
Infect Control Hosp Epidemiol. 2000 Jan;21(1 Suppl):S22-31. doi: 10.1086/503170.
6
Prediction of poorer prognosis by infection with antibiotic-resistant gram-positive cocci than by infection with antibiotic-sensitive strains.抗生素耐药革兰氏阳性球菌感染比抗生素敏感菌株感染预后更差的预测。
Arch Surg. 1999 Oct;134(10):1033-40. doi: 10.1001/archsurg.134.10.1033.
7
Characterization of MexT, the regulator of the MexE-MexF-OprN multidrug efflux system of Pseudomonas aeruginosa.铜绿假单胞菌MexE-MexF-OprN多药外排系统调控因子MexT的特性分析
J Bacteriol. 1999 Oct;181(20):6300-5. doi: 10.1128/JB.181.20.6300-6305.1999.
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Integrons and gene cassettes: a genetic construction kit for bacteria.
J Antimicrob Chemother. 1999 Jan;43(1):1-4.
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Scheduled change of antibiotic classes: a strategy to decrease the incidence of ventilator-associated pneumonia.抗生素类别定期更换：一种降低呼吸机相关性肺炎发病率的策略。
Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1040-8. doi: 10.1164/ajrccm.156.4.9701046.
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Manipulation of a hospital antimicrobial formulary to control an outbreak of vancomycin-resistant enterococci.通过调整医院抗菌药物处方集来控制耐万古霉素肠球菌的暴发。
Clin Infect Dis. 1996 Nov;23(5):1020-5. doi: 10.1093/clinids/23.5.1020.