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多重耐药菌感染治疗的推荐意见和指南。

Recommendations and guidelines for the treatment of infections due to multidrug resistant organisms.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

J Microbiol Immunol Infect. 2022 Jun;55(3):359-386. doi: 10.1016/j.jmii.2022.02.001. Epub 2022 Mar 16.

Abstract

Antimicrobial drug resistance is one of the major threats to global health. It has made common infections increasingly difficult or impossible to treat, and leads to higher medical costs, prolonged hospital stays and increased mortality. Infection rates due to multidrug-resistant organisms (MDRO) are increasing globally. Active agents against MDRO are limited despite an increased in the availability of novel antibiotics in recent years. This guideline aims to assist clinicians in the management of infections due to MDRO. The 2019 Guidelines Recommendations for Evidence-based Antimicrobial agents use in Taiwan (GREAT) working group, comprising of infectious disease specialists from 14 medical centers in Taiwan, reviewed current evidences and drafted recommendations for the treatment of infections due to MDRO. A nationwide expert panel reviewed the recommendations during a consensus meeting in Aug 2020, and the guideline was endorsed by the Infectious Diseases Society of Taiwan (IDST). This guideline includes recommendations for selecting antimicrobial therapy for infections caused by carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Pseudomonas aeruginosa, carbapenem-resistant Enterobacterales, and vancomycin-resistant Enterococcus. The guideline takes into consideration the local epidemiology, and includes antimicrobial agents that may not yet be available in Taiwan. It is intended to serve as a clinical guide and not to supersede the clinical judgment of physicians in the management of individual patients.

摘要

抗菌药物耐药性是全球健康的主要威胁之一。它使常见感染越来越难以治疗,导致医疗费用增加、住院时间延长和死亡率增加。全球耐多药生物体(MDRO)感染率正在上升。尽管近年来新型抗生素的供应增加,但针对 MDRO 的有效药物仍然有限。本指南旨在协助临床医生治疗 MDRO 引起的感染。由来自台湾 14 家医疗中心的传染病专家组成的 2019 年台湾抗菌药物使用循证指南(GREAT)工作组,审查了当前的证据,并为治疗 MDRO 引起的感染制定了建议。一个全国性的专家小组在 2020 年 8 月的共识会议上审查了这些建议,该指南得到了台湾感染病学会(IDST)的认可。本指南包括针对耐碳青霉烯鲍曼不动杆菌、耐碳青霉烯铜绿假单胞菌、耐碳青霉烯肠杆菌科和耐万古霉素肠球菌引起的感染选择抗菌治疗的建议。本指南考虑了当地的流行病学情况,并包括了可能尚未在台湾上市的抗菌药物。它旨在作为临床指南,而不是取代医生在治疗个别患者时的临床判断。

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