传染病的诊断不确定性:倡导一种鼻病学框架
Pierre-Marie Roger1, Olivia Keïta-Perse2, Jean-Luc Mainardi3
1Infectiologie, Centre Hospitalier Universitaire de Guadeloupe, France; Faculté de Médecine, Université des Antilles, France.
Infectious diseases now
|July 8, 2023
概括
诊断不确定性 (DU) 显著影响传染病 (ID) 患者的护理,往往导致不必要的抗生素使用. 清晰的DU定义对于更好的临床管理和抗生素管理至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 临床医学 临床医学
- 诊断方面的挑战
背景情况:
- 诊断不确定性 (DU) 影响10-50%的感染性疾病 (ID) 患者.
- 随着时间的推移,在各种临床环境中,大量的 DU 持续存在.
- 当前的指导方针往往忽略了 DU,以假定诊断为基础的治疗.
研究的目的:
- 突出传染病诊断不确定性的持续挑战.
- 强调需要根据DU重新评估经验性抗生素治疗的需要.
- 倡导对 DU 达成共识的定义,以指导临床实践和研究.
主要方法:
- 对临床实践和有关诊断不确定性的现有指导方针的审查.
- 分析DU对抗生素处方和患者管理的影响.
- 讨论DU对医学教育和研究的影响.
主要成果:
- 诊断不确定性是传染病的常见问题,经常导致不必要的广泛抗生素使用.
- 许多非传染性疾病模仿败血症,使诊断和治疗复杂化.
- 无菌微生物样本很常见,这凸显了在患者随访中 DU 的持续挑战.
结论:
- 对诊断不确定性的共识定义对于其临床识别和管理至关重要.
- 解决DU可以改善抗生素管理,减少不必要的治疗,并指导未来的研究.
- 澄清DU将提高医生问责制和传染病方面的医疗培训.
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