Hoth J Jason, Franklin Glen A, Stassen Nicole A, Girard Stephen M, Rodriguez Roman J, Rodriguez Jorge L
Department of Surgery, University of Louisville School of Medicine, Kentucky 40292, USA.
J Trauma. 2003 Aug;55(2):249-54. doi: 10.1097/01.TA.0000083334.93868.65.
Little data are available regarding the impact that prolonged prophylactic antibiotic use (>48 hours) has on the development of nosocomial pneumonia. This retrospective study was conducted to assess the effect that prolonged prophylactic antibiotic use has on the development of nosocomial pneumonia and antibiotic use complications.
The records of patients who contracted nosocomial pneumonia during mechanical ventilation were retrospectively reviewed. These patients then were classified into two groups: those who received prolonged prophylactic antibiotics before the diagnosis of pneumonia and those who did not receive antibiotics.
For the patients who received prolonged prophylactic antibiotics, the first pneumonia was diagnosed later, the causative organisms were more likely to be resistant or Gram-negative bacteria, and the incidence of antibiotic complications were two times greater than for patients who did not receive extended antibiotic prophylaxis.
Justification for the use and duration of prolonged (>48 hours) prophylactic antibiotics requires careful reevaluation because this practice is associated with significant clinical complications that lead to increased use of patient resources, lengthened hospital stay, and higher cost.
关于延长预防性抗生素使用时间（>48小时）对医院获得性肺炎发生的影响，目前可用数据较少。本回顾性研究旨在评估延长预防性抗生素使用时间对医院获得性肺炎发生及抗生素使用并发症的影响。
对机械通气期间发生医院获得性肺炎的患者记录进行回顾性审查。这些患者随后被分为两组：在肺炎诊断前接受延长预防性抗生素治疗的患者和未接受抗生素治疗的患者。
对于接受延长预防性抗生素治疗的患者，首次肺炎诊断较晚，致病微生物更可能是耐药菌或革兰氏阴性菌，且抗生素并发症的发生率比未接受延长抗生素预防的患者高两倍。
延长（>48小时）预防性抗生素使用的合理性及持续时间需要仔细重新评估，因为这种做法会导致显著的临床并发症，进而增加患者资源的使用、延长住院时间并增加费用。
