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权衡选择：社区获得性肺炎重症患者的经验性抗生素使用及管理机会

Weighing options: empiric antibiotic use and stewardship opportunities in critically ill patients with community-acquired pneumonia.

作者信息

Trujillo Nalea, Diep Calvin, Ha David, Garcia Ariadna, Holubar Marisa

机构信息

Department of Pharmacy, Stanford Health Care, Stanford, CA, USA.

Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Antimicrob Steward Healthc Epidemiol. 2025 Aug 7;5(1):e180. doi: 10.1017/ash.2025.10082. eCollection 2025.

DOI:10.1017/ash.2025.10082
PMID:40808903
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12345047/
Abstract

In this retrospective study, critically ill patients with community-acquired pneumonia frequently received empiric anti-methicillin-resistant Staphylococcus aureus (MRSA) and antipseudomonal antibiotics despite having few or no guidelines-endorsed risk factors. De-escalation of anti-MRSA therapy was quicker, likely aided by MRSA polymerase chain reaction assays.

摘要

在这项回顾性研究中，社区获得性肺炎的重症患者尽管几乎没有或完全没有指南认可的风险因素，但仍经常接受经验性抗耐甲氧西林金黄色葡萄球菌（MRSA）和抗假单胞菌抗生素治疗。抗MRSA治疗的降阶梯更快，这可能得益于MRSA聚合酶链反应检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2260/12345047/80585f23bf11/S2732494X2510082X_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2260/12345047/776b22e4d751/S2732494X2510082X_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2260/12345047/80585f23bf11/S2732494X2510082X_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2260/12345047/776b22e4d751/S2732494X2510082X_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2260/12345047/80585f23bf11/S2732494X2510082X_fig2.jpg

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本文引用的文献

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Prevention and Treatment of Cancer-Related Infections, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology.癌症相关感染的预防和治疗，第 3.2024 版，NCCN 肿瘤学临床实践指南。
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社区获得性肺炎耐甲氧西林金黄色葡萄球菌和 感染的危险因素评估。
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Empirical Anti-MRSA vs Standard Antibiotic Therapy and Risk of 30-Day Mortality in Patients Hospitalized for Pneumonia.经验性抗耐甲氧西林金黄色葡萄球菌（MRSA）治疗与肺炎住院患者 30 天死亡率的关系。
JAMA Intern Med. 2020 Apr 1;180(4):552-560. doi: 10.1001/jamainternmed.2019.7495.
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Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.成人社区获得性肺炎诊断和治疗。美国胸科学会和美国传染病学会的官方临床实践指南。
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