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新生儿重症监护病房常见病症抗菌治疗实践总结:加拿大视角

Practice Summary of Antimicrobial Therapy for Commonly Encountered Conditions in the Neonatal Intensive Care Unit: A Canadian Perspective.

作者信息

Ting Joseph Y, Autmizguine Julie, Dunn Michael S, Choudhury Julie, Blackburn Julie, Gupta-Bhatnagar Shikha, Assen Katrin, Emberley Julie, Khan Sarah, Leung Jessica, Lin Grace J, Lu-Cleary Destiny, Morin Frances, Richter Lindsay L, Viel-Thériault Isabelle, Roberts Ashley, Lee Kyong-Soon, Skarsgard Erik D, Robinson Joan, Shah Prakesh S

机构信息

Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.

Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.

出版信息

Front Pediatr. 2022 Jul 8;10:894005. doi: 10.3389/fped.2022.894005. eCollection 2022.

Abstract

Neonates are highly susceptible to infections owing to their immature cellular and humoral immune functions, as well the need for invasive devices. There is a wide practice variation in the choice and duration of antimicrobial treatment, even for relatively common conditions in the NICU, attributed to the lack of evidence-based guidelines. Early decisive treatment with broad-spectrum antimicrobials is the preferred clinical choice for treating sick infants with possible bacterial infection. Prolonged antimicrobial exposure among infants without clear indications has been associated with adverse neonatal outcomes and increased drug resistance. Herein, we review and summarize the best practices from the existing literature regarding antimicrobial use in commonly encountered conditions in neonates.

摘要

由于新生儿的细胞和体液免疫功能不成熟,以及需要使用侵入性设备,他们极易受到感染。即使对于新生儿重症监护病房(NICU)中相对常见的病症,抗菌治疗的选择和持续时间在实践中也存在很大差异,这归因于缺乏循证指南。对于可能患有细菌感染的患病婴儿,早期使用广谱抗菌药物进行果断治疗是首选的临床选择。在没有明确指征的婴儿中长时间使用抗菌药物已被证明与不良的新生儿结局及耐药性增加有关。在此,我们回顾并总结了现有文献中关于新生儿常见病症抗菌药物使用的最佳实践。

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