ICU 疑似 ICU 获得性感染患者的抗菌药物保守启动：欲速则不达。
Conservative initiation of antimicrobial treatment in ICU patients with suspected ICU-acquired infection: more haste less speed.
机构信息
University of Virginia, Charlottesville, Virginia, USA.
出版信息
Curr Opin Crit Care. 2013 Oct;19(5):461-4. doi: 10.1097/MCC.0b013e328364d525.
Abstract
PURPOSE OF REVIEW
To review the recent literature supporting the idea that in some patients suspected of having a new ICU-acquired infection, antibiotics can be withheld until evidence to confirm diagnosis is obtained.
RECENT FINDINGS
Recent publications demonstrate that in community-acquired pneumonia, severe sepsis presenting to the emergency room, and suspected ICU-acquired infection, the time to antibiotic therapy does not necessarily seem to be a key determinant of outcome.
SUMMARY
In the ICU, patients without septic shock but suspected of having an ICU-acquired infection may be able to have antibiotics withheld until infection is confirmed using a combination of laboratory, radiologic, and microbiological data.
摘要
目的综述
回顾近期文献，以支持在某些疑似新发生 ICU 获得性感染的患者中，可在获得确诊依据之前暂时停用抗生素的观点。
最近的发现
近期文献表明，在社区获得性肺炎、急诊严重脓毒症和疑似 ICU 获得性感染中，抗生素治疗时间似乎不一定是决定预后的关键因素。
总结
在 ICU 中，没有感染性休克但疑似发生 ICU 获得性感染的患者，可暂时停用抗生素，直到使用实验室、影像学和微生物学数据组合确认感染。
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本文引用的文献
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Aggressive versus conservative initiation of antimicrobial treatment in critically ill surgical patients with suspected intensive-care-unit-acquired infection: a quasi-experimental, before and after observational cohort study.危重症外科患者疑似 ICU 获得性感染时采用积极与保守抗菌治疗策略的比较：一项准实验、前后观察性队列研究。
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Association between timing of antibiotic administration and mortality from septic shock in patients treated with a quantitative resuscitation protocol.在接受定量复苏方案治疗的脓毒性休克患者中，抗生素给药时机与死亡率之间的关系。
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