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台湾地区艰难梭菌感染治疗的推荐意见和指南。

Recommendations and guidelines for the treatment of Clostridioides difficile infection in Taiwan.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.

Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.

出版信息

J Microbiol Immunol Infect. 2020 Apr;53(2):191-208. doi: 10.1016/j.jmii.2020.02.002. Epub 2020 Feb 14.

Abstract

Clostridioides difficile infection (CDI) is a major enteric disease associated with antibiotic use and a leading cause of hospital-acquired infections worldwide. This is the first guideline for treatment of CDI in Taiwan, aiming to optimize medical care for patients with CDI. The target audience of this document includes all healthcare personnel who are involved in the medical care of patients with CDI. The 2018 Guidelines Recommendations for Evidence-based Antimicrobial agents use in Taiwan (GREAT) working group was formed, comprising of infectious disease specialists from 13 medical centers in Taiwan, to review the evidence and draft recommendations using the grading of recommendations assessment, development, and evaluation (GRADE) methodology. A nationwide expert panel reviewed the recommendations during a consensus meeting in March 2019. The recommendation is endorsed by the Infectious Diseases Society of Taiwan (IDST). This guideline describes the epidemiology and risk factors of CDI, and provides recommendations for treatment of CDI in both adults and children. Recommendations for treatment of the first episode of CDI, first recurrence, second and subsequent recurrences of CDI, severe CDI, fulminant CDI, and pediatric CDI are provided.

摘要

艰难梭菌感染(CDI)是一种与抗生素使用相关的主要肠道疾病,也是全球医院获得性感染的主要原因。这是台湾首个艰难梭菌感染治疗指南,旨在优化艰难梭菌感染患者的医疗护理。本文件的目标受众包括所有参与艰难梭菌感染患者医疗护理的医疗保健人员。成立了 2018 年台湾基于证据的抗菌药物使用指南推荐(GREAT)工作组,由来自台湾 13 家医疗中心的传染病专家组成,使用推荐评估、制定和评估(GRADE)方法学审查证据并起草建议。一个全国性的专家小组在 2019 年 3 月的共识会议上审查了这些建议。该建议得到了台湾传染病学会(IDST)的认可。本指南描述了 CDI 的流行病学和危险因素,并提供了成人和儿童 CDI 治疗的建议。提供了治疗 CDI 首发、首次复发、第二次及以后复发、严重 CDI、暴发性 CDI 和儿科 CDI 的建议。

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