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成人社区获得性肺炎的诊断和治疗:中华医学会呼吸病学分会2016年临床实践指南

Diagnosis and treatment of community-acquired pneumonia in adults: 2016 clinical practice guidelines by the Chinese Thoracic Society, Chinese Medical Association.

作者信息

Cao Bin, Huang Yi, She Dan-Yang, Cheng Qi-Jian, Fan Hong, Tian Xin-Lun, Xu Jin-Fu, Zhang Jing, Chen Yu, Shen Ning, Wang Hui, Jiang Mei, Zhang Xiang-Yan, Shi Yi, He Bei, He Li-Xian, Liu You-Ning, Qu Jie-Ming

机构信息

National Clinical Research Center of Respiratory Diseases, Center for Respiratory Diseases, China-Japan Friendship Hospital, Capital Medical University, Beijing 100029, China.

Department of Respiratory and Critical Care Medicine, Changhai Hospital, the Second Military Medical University, Shanghai 200433, China.

出版信息

Clin Respir J. 2018 Apr;12(4):1320-1360. doi: 10.1111/crj.12674. Epub 2017 Sep 26.

Abstract

Community-acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence. Corresponding recommendations are provided appropriately based on the level of evidence. This updated guideline covers comprehensive topics on CAP, including aetiology, antimicrobial resistance profile, diagnosis, empirical and targeted treatments, adjunctive and supportive therapies, as well as prophylaxis. The recommendations may help clinicians manage CAP patients more effectively and efficiently. CAP in pediatric patients and immunocompromised adults is beyond the scope of this guideline. This guideline is only applicable for the immunocompetent CAP patients aged 18 years and older. The recommendations on selection of antimicrobial agents and the dosing regimens are not mandatory. The clinicians are recommended to prescribe and adjust antimicrobial therapies primarily based on their local etiological profile and results of susceptibility testing, with reference to this guideline.

摘要

成人社区获得性肺炎(CAP)是一种在中国及世界其他地区发病率较高的传染病。随着CAP病原学特征模式的变化以及医学诊断和治疗技术的不断进步,中华医学会呼吸病学分会于2016年更新了CAP指南,以规范中国成人CAP的标准管理。通过广泛而全面的文献检索收集数据和证据,供专家审查和评估证据水平,并根据证据水平适当提供相应建议。本更新指南涵盖了CAP的综合主题,包括病因、抗菌药物耐药情况、诊断、经验性和靶向治疗、辅助和支持治疗以及预防。这些建议可能有助于临床医生更有效、高效地管理CAP患者。儿科患者和免疫功能低下成人的CAP不在本指南范围内。本指南仅适用于18岁及以上免疫功能正常的CAP患者。关于抗菌药物选择和给药方案的建议并非强制性的。建议临床医生主要根据当地的病原学特征和药敏试验结果,并参考本指南来开具和调整抗菌治疗方案。

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