Stone H H, Bourneuf A A, Stinson L D
Arch Surg. 1985 Jan;120(1):17-20. doi: 10.1001/archsurg.1985.01390250011002.
We reviewed the charts of 2,567 patients from 11 prospective clinical trials of antibiotic therapy for surgical infection to identify reliable predictors of sepsis eradication. Particular attention was paid to temperature, blood cell counts, renal and hepatic function tests, arterial gases, and clotting factors, both at the termination of parenteral antibiotic administration as well as at patient discharge from the hospital. On the discontinuation of antibiotic therapy, sepsis recurred in 19% of the patients who had a normal rectal temperature, in 3% of the patients if the rectal temperature and WBC count were normal, but in no patient when both the temperature and WBC count were normal and the differential blood smear contained less than 73% granulocytes and less than 3% immature forms. Rates for recurrent sepsis, once antibiotic therapy was discontinued for more than 48 hours, were 8%, 2%, and 0%, respectively, for the same criteria at hospital discharge.
我们回顾了11项外科感染抗生素治疗前瞻性临床试验中2567例患者的病历，以确定脓毒症根除的可靠预测指标。特别关注了胃肠外抗生素给药结束时以及患者出院时的体温、血细胞计数、肾功能和肝功能测试、动脉血气及凝血因子。抗生素治疗停止后，直肠温度正常的患者中19%脓毒症复发，直肠温度和白细胞计数均正常的患者中3%复发，但当体温和白细胞计数均正常且差示血涂片粒细胞少于73%、未成熟细胞少于3%时无患者复发。对于相同标准，抗生素治疗停止超过48小时后，出院时脓毒症复发率分别为8%、2%和0%。
