Mazer-Amirshahi Maryann, Pourmand Ali, May Larissa
Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, DC; Georgetown University School of Medicine, Washington, DC.
Department of Emergency Medicine, The George Washington University, Washington, DC; The George Washington University, School of Medicine and Health Sciences, Washington, DC.
Am J Emerg Med. 2017 Jan;35(1):154-158. doi: 10.1016/j.ajem.2016.10.034. Epub 2016 Oct 17.
Millions of patients are evaluated every year in the emergency department (ED) for bacterial infections. Emergency physicians often diagnose and prescribe initial antibiotic therapy for a variety of bacterial infections, ranging from simple urinary tract infections to severe sepsis. In life-threatening infections, inappropriate choice of initial antibiotic has been shown to increase morbidity and mortality. As such, initiation of appropriate antibiotic therapy on the part of the emergency physician is critical. Increasing rates of antibiotic resistance, drug allergies, and antibiotic shortages further complicates the choice of antibiotics. Patients may have a history of prior resistant infections or culture data indicating that common first-line antibiotics used in the ED may be ineffective. In recent years, there have been several new antibiotic approvals as well as renewed interest in second and third line antibiotics because of the aforementioned concerns. In addition, several newly approved antibiotics have the advantage of being administered once weekly or even as a single infusion, which has the potential to decrease hospitalizations and healthcare costs. This article reviews newly approved antibiotics and antibiotics used to treat resistant infections with a focus on implications for emergency medicine.
每年有数百万人在急诊科接受细菌感染评估。急诊医生经常对各种细菌感染进行诊断并开出初始抗生素治疗方案，范围从简单的尿路感染到严重脓毒症。在危及生命的感染中，初始抗生素选择不当已被证明会增加发病率和死亡率。因此，急诊医生开始使用适当的抗生素治疗至关重要。抗生素耐药性、药物过敏和抗生素短缺率不断上升，进一步使抗生素的选择复杂化。患者可能有既往耐药感染病史或培养数据表明急诊科常用的一线抗生素可能无效。近年来，由于上述担忧，有几种新抗生素获批，同时对二线和三线抗生素的兴趣也重新燃起。此外，几种新获批的抗生素具有每周给药一次甚至单次输注的优势，这有可能减少住院次数和医疗费用。本文回顾新获批的抗生素以及用于治疗耐药感染的抗生素，重点关注对急诊医学的影响。
