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降钙素原指导下的危重症成年患者抗生素治疗疗程

Procalcitonin-guided antibiotic therapy duration in critically ill adults.

作者信息

Walker Caroline

机构信息

Caroline Walker is Adult Gerontology Acute Care Nurse Practitioner, University of Pennsylvania School of Nursing, 418 Curie Boulevard, Philadelphia, PA 19104 (

出版信息

AACN Adv Crit Care. 2015 Apr-Jun;26(2):99-106. doi: 10.1097/NCI.0000000000000079.

Abstract

Procalcitonin is a promising biomarker for antibiotic therapy because its levels rise and fall quickly with bacterial infections. A multidatabase literature search was reviewed with 3 primary prospective randomized control trials used in further analysis. The results indicated that a procalcitonin-guided antibiotic protocol reduces the number of days a patient has to take antibiotics while having no effect on mortality when compared with control groups. Short-term studies did not show a difference in the intensive care unit length of stay, infection relapse rate, superinfection rate, or multidrug-resistant bacteria rate between the procalcitonin-protocol and control group. Because procalcitonin-guided antibiotic therapy has been shown to reduce the duration of treatment with antibiotics in critically ill patients without worsening the mortality rate or other outcomes, the implementation of a procalcitonin-guided antibiotic therapy should be considered for patients with proven or highly suspected bacterial infections in the intensive care unit.

摘要

降钙素原是一种很有前景的抗生素治疗生物标志物,因为其水平会随着细菌感染迅速上升和下降。对多数据库文献检索进行了回顾,并使用3项主要的前瞻性随机对照试验进行进一步分析。结果表明,与对照组相比,降钙素原指导的抗生素方案减少了患者服用抗生素的天数,同时对死亡率没有影响。短期研究未显示降钙素原方案组和对照组在重症监护病房住院时间、感染复发率、二重感染率或多重耐药菌率方面存在差异。由于降钙素原指导的抗生素治疗已被证明可缩短重症患者的抗生素治疗时间,且不会使死亡率或其他结果恶化,因此对于重症监护病房中已证实或高度怀疑细菌感染的患者,应考虑实施降钙素原指导的抗生素治疗。

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