成年人感染性内心炎的诊断和管理指南:维基指南小组共识声明
Emily G McDonald1, Gloria Aggrey2, Abdullah Tarik Aslan3
1Division of General Internal Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada.
JAMA network open
|July 31, 2023
概括
口服过渡疗法在治疗感染性内心炎 (IE) 方面与仅静脉注射疗法同样有效. 这一发现为管理细菌IE提供了关键建议,指导临床实践并改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 临床指南 临床指南
背景情况:
- 实践指南经常提出建议,建议的强度与证据的质量不一致.
- 在临床指南中,证据质量和建议强度之间存在差距.
研究的目的:
- 制定诊断和管理成人细菌性传染性内心炎 (IE) 的临床指南.
- 解决IE管理中证据质量和建议强度之间的差异.
主要方法:
- 一份共识声明和系统审查,使用维基指南方法合作制定指南.
- 在与成人细菌IE诊断和管理相关的主题上进行众包和投票.
- 在PubMed中进行文献搜索,根据可重复,前性,受控研究进行证据报告,以获得明确的建议.
主要成果:
- 来自10个国家的51名成员审查了587篇文章,解决了诊断,IE团队,预防和治疗方面的17个独特问题.
- 根据3项随机临床试验,只对一个问题制定了一个明确的建议:口服过渡疗法在IE治疗中与仅静脉注射疗法一样有效.
- 由于缺乏足够的高质量证据,为剩余问题生成了临床审查.
结论:
- 应用了WikiGuideline方法来制定成人细菌IE的共识声明.
- 口服过渡疗法被证明与仅为静脉注射的治疗对IE治疗一样有效.
- 需要进一步的研究和正在进行的临床试验,以告知IE实践的其他方面.
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