关于早期口服降阶梯疗法治疗非复杂性菌血症的叙述性综述：是或否？
A Narrative Review of Early Oral Stepdown Therapy for the Treatment of Uncomplicated Bacteremia: Yay or Nay?
作者信息
Dagher Michael, Fowler Vance G, Wright Patty W, Staub Milner B
机构信息
Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.
Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
出版信息
Open Forum Infect Dis. 2020 May 5;7(6):ofaa151. doi: 10.1093/ofid/ofaa151. eCollection 2020 Jun.
Abstract
Historically, intravenous (IV) antibiotics have been the cornerstone of treatment for uncomplicated bacteremia (SAB). However, IV antibiotics are expensive, increase the rates of hospital readmission, and can be associated with catheter-related complications. As a result, the potential role of oral antibiotics in the treatment of uncomplicated SAB has become a subject of interest. This narrative review article aims to summarize key arguments for and against the use of oral antibiotics to complete treatment of uncomplicated SAB and evaluates the available evidence for specific oral regimens. We conclude that evidence suggests that oral step-down therapy can be an alternative for select patients who meet the criteria for uncomplicated SAB and will comply with medical treatment and outpatient follow-up. Of the currently studied regimens discussed in this article, linezolid has the most support, followed by fluoroquinolone plus rifampin.
摘要
从历史上看，静脉注射（IV）抗生素一直是单纯性菌血症（SAB）治疗的基石。然而，静脉注射抗生素价格昂贵，会增加再次入院率，并且可能与导管相关并发症有关。因此，口服抗生素在单纯性SAB治疗中的潜在作用已成为一个备受关注的话题。这篇叙述性综述文章旨在总结支持和反对使用口服抗生素完成单纯性SAB治疗的关键论点，并评估特定口服治疗方案的现有证据。我们得出结论，有证据表明，对于符合单纯性SAB标准且会遵守医疗治疗和门诊随访的特定患者，口服降阶梯疗法可以作为一种替代方案。在本文讨论的目前已研究的治疗方案中，利奈唑胺得到的支持最多，其次是氟喹诺酮类药物加利福平。
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