Niven Daniel J, Laupland Kevin B
Department of Medicine, University of Calgary, and Calgary Health Region, Calgary, AB, Canada.
Expert Rev Anti Infect Ther. 2009 Feb;7(1):69-81. doi: 10.1586/14787210.7.1.69.
Severe community-acquired pneumonia (CAP) is the most common infectious cause of admission to the intensive care unit and is associated with significant adverse outcomes. Antimicrobial therapy is a major aspect in the management of patients with severe CAP. This review focuses on antimicrobial therapies for severe CAP, including selection of empiric antibiotic therapy, the use of specific agents in mono or combination therapy and the duration of therapy. Early appropriate antimicrobial therapy with revision following culture confirmation, is a mainstay of therapy. There is limited evidence to guide the use of specific drugs, multidrug effective regimens and the duration of therapy, and an individualized approach is needed.
重症社区获得性肺炎(CAP)是重症监护病房最常见的感染性入院原因,且与显著不良后果相关。抗菌治疗是重症CAP患者管理的一个主要方面。本综述聚焦于重症CAP的抗菌治疗,包括经验性抗生素治疗的选择、单一或联合治疗中特定药物的使用以及治疗疗程。早期进行适当抗菌治疗并在培养结果确认后进行调整,是治疗的主要支柱。指导特定药物、多药有效方案及治疗疗程使用的证据有限,需要采取个体化方法。