Wintenberger C, Guery B, Bonnet E, Castan B, Cohen R, Diamantis S, Lesprit P, Maulin L, Péan Y, Peju E, Piroth L, Stahl J P, Strady C, Varon E, Vuotto F, Gauzit R
Département de médecine interne, CHU de Grenoble Alpes, 38043 Grenoble, France.
Service de maladies infectieuses, CHU vaudois et université de Lausanne, Lausanne, Switzerland.
Med Mal Infect. 2017 Mar;47(2):92-141. doi: 10.1016/j.medmal.2017.01.007. Epub 2017 Mar 6.
Reducing antibiotic consumption has now become a major public health priority. Reducing treatment duration is one of the means to achieve this objective. Guidelines on the therapeutic management of the most frequent infections recommend ranges of treatment duration in the ratio of one to two. The Recommendation Group of the French Infectious Diseases Society (SPILF) was asked to collect literature data to then recommend the shortest treatment durations possible for various infections.
Analysis of the literature focused on guidelines published in French and English, supported by a systematic search on PubMed. Articles dating from one year before the guidelines publication to August 31, 2015 were searched on the website.
The shortest treatment durations based on the relevant clinical data were suggested for upper and lower respiratory tract infections, central venous catheter-related and uncomplicated primary bacteremia, infective endocarditis, bacterial meningitis, intra-abdominal, urinary tract, upper reproductive tract, bone and joint, skin and soft tissue infections, and febrile neutropenia. Details of analyzed articles were shown in tables.
This work stresses the need for new well-conducted studies evaluating treatment durations for some common infections. Following the above-mentioned work focusing on existing literature data, the Recommendation Group of the SPILF suggests specific study proposals.
减少抗生素使用现已成为一项重大的公共卫生优先事项。缩短治疗疗程是实现这一目标的手段之一。针对最常见感染的治疗管理指南推荐了一到两倍的治疗疗程范围。法国传染病学会(SPILF)的推荐小组被要求收集文献数据,以便为各种感染推荐尽可能最短的治疗疗程。
文献分析聚焦于以法语和英语发表的指南,并在PubMed上进行系统检索予以支持。在该网站上搜索了从指南发布前一年到2015年8月31日的文章。
基于相关临床数据,针对上、下呼吸道感染、中心静脉导管相关和非复杂性原发性菌血症、感染性心内膜炎、细菌性脑膜炎、腹腔内、泌尿系统、上生殖道、骨与关节、皮肤和软组织感染以及发热性中性粒细胞减少症,提出了最短治疗疗程建议。分析文章的详细信息列于表格中。
这项工作强调需要开展新的、精心实施的研究来评估某些常见感染的治疗疗程。在上述聚焦现有文献数据的工作之后,SPILF推荐小组提出了具体的研究建议。