质疑14天候血症的教条 治疗持续时间
Jon Salmanton-García1,2,3, Ilana Reinhold4, Juergen Prattes5
1Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Institute of Translational Research, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Mycoses
|October 28, 2023
概括
抗微生物药物耐药性 (AMR) 需要优化治疗方法,如候选血症. 目前的14天抗真菌疗法可能是可减少的,可能降低耐药性并改善患者的治疗结果.
科学领域:
- 传染性疾病 传染性疾病
- 抗微生物药物管理委员会
- 临床微生物学 临床微生物学
背景情况:
- 抗菌素耐药性 (AMR) 构成了全球健康的重大威胁,每年造成数百万人的死亡.
- 优化抗微生物药物的使用对于减轻AMR至关重要,特别是在严重的感染中,如候选性血症.
- 标准的14天治疗白血病缺乏来自随机试验的强有力的证据来挑战这一最低持续时间.
研究的目的:
- 审查现有的关于血病治疗持续时间的文献.
- 评估证据支持目前的14天的最低治疗指南.
- 探索更短的治疗持续时间对AMR和患者结果的潜在影响.
主要方法:
- 在2023年8月进行了全面的文献搜索.
- 包含的研究是原创文章和案例系列,讨论候群血病治疗持续时间.
- 搜索了干预试验或对更短治疗持续时间的前性观察研究.
主要成果:
- 七篇原创文章和两篇病例系列报告了候选血病治疗持续时间短于14天.
- 没有发现评估更短持续时间的干预或前性观察性研究.
- 历史数据和最近的研究表明,较短和较长的治疗时间之间没有显著的生存差异.
结论:
- 目前对候选血症的最低14天治疗可能不是基于证据的,需要重新评估.
- 通过缩短治疗后清除来减少抗真菌暴露,可以减轻AMR.
- 进一步的研究和临床试验至关重要,以建立基于证据的指导方针,以确定最佳的血症治疗持续时间.
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