Zhonghua Yi Xue Za Zhi. 2023 Aug 15;103(30):2281-2296. doi: 10.3760/cma.j.cn112137-20230313-00389.
In recent years, the emergence of newly detected pathogens and the increase of drug resistant bacterial bring serious challenges for the diagnosis and treatment of infectious diseases. Tetracycline drugs are widely used in clinical practice, and the varieties of these drugs are constantly being updated. However, there is still a lack of guidance documents for the rational clinical application of tetracycline drugs in China. Meanwhile, some healthcare workers have doubts about their pharmaceutical characteristics, timing and methods of clinical application. In order to further standardize the clinical application of tetracycline drugs and provide professional evidence-based medicine suggestions for medical personnel in medical institutions, under the leadership of Hospital Infection Control Branch of Chinese Preventive Medicine Association and Clinical Pharmacology Branch of Chinese Pharmacological Society, experts from areas of infection, respiratory medicine, critical care medicine, emergency, infection control, pharmacy and other disciplines organized a consensus meeting and formulated multidisciplinary expert consensus on the rational use of tetracyclines commonly used in clinical practice. This expert consensus is based on the pharmaceutical characteristics of tetracyclines commonly used in China, the mechanism of action and drug resistance status of tetracyclines, combined with the infection site, pathogen characteristics and bacterial drug resistance. This expert consensus also pays attention to special populations and off-label drug use, and integrates domestic and foreign recommendations and the latest evidence-based medicine evidence, and 17 expert consensus opinions for clinical physicians, pharmacists, and other professionals in medical institutions to refer to were formed. In view of the particularity and complexity of infectious diseases and the individual differences of patients, in order to benefit patients, individualized anti-infection strategies should be implemented.
近年来,新发现病原体的出现以及耐药菌的增加给传染病的诊断和治疗带来了严峻挑战。四环素类药物在临床实践中广泛应用,且这类药物的品种不断更新。然而,我国仍缺乏四环素类药物临床合理应用的指导文件。同时,部分医护人员对其药学特点、临床应用时机及方法存在疑问。为进一步规范四环素类药物的临床应用,为医疗机构医务人员提供专业的循证医学建议,在中国预防医学会医院感染控制分会和中国药理学会临床药理学分会的领导下,感染、呼吸内科、重症医学、急诊、感染控制、药学等多学科领域的专家组织了一次共识会议,制定了关于临床常用四环素类药物合理使用的多学科专家共识。本专家共识基于我国常用四环素类药物的药学特点、四环素类药物的作用机制及耐药状况,结合感染部位、病原体特征及细菌耐药情况。本专家共识还关注特殊人群及超说明书用药情况,整合了国内外推荐意见及最新的循证医学证据,形成了17条专家共识意见供医疗机构临床医师、药师等专业人员参考。鉴于传染病的特殊性和复杂性以及患者的个体差异,为使患者受益,应实施个体化抗感染策略。