Niederman M S
Department of Medicine, State University of New York at Stony Brook.
Med Clin North Am. 1994 Sep;78(5):1123-41. doi: 10.1016/s0025-7125(16)30123-7.
Because many studies show that antibiotic therapy is effective for nosocomial pneumonia, it is necessary to have an approach to antibiotic selection to reduce mortality. Empiric therapy can be chosen, based on an assessment of patient risk factors for specific organisms and on an evaluation of the severity of illness present. Empiric regimens must be selected from a knowledge of antibiotic pharmacodynamics, as well as from an appreciation of the antimicrobial spectrum of the various antibacterials. When using such an approach, it is necessary to realize the limitations of effective therapy and to evaluate a number of relevant issues if the patient is not improving during treatment.
由于许多研究表明抗生素治疗对医院获得性肺炎有效，因此有必要采用一种抗生素选择方法以降低死亡率。经验性治疗可根据对患者特定病原体风险因素的评估以及对当前疾病严重程度的评估来选择。经验性治疗方案必须基于对抗生素药效学的了解以及对各种抗菌药物抗菌谱的认识来选择。采用这种方法时，有必要认识到有效治疗的局限性，并在治疗期间患者病情无改善的情况下评估一些相关问题。
