欧洲对CDI治疗的实践
Fidelma Fitzpatrick1,2, Robert Brennan3, Joffrey van Prehn4
1Department of Clinical Microbiology, The Royal College of Surgeons in Ireland, Dublin, Ireland. fidelmafitzpatrick@rcsi.ie.
Advances in experimental medicine and biology
|January 4, 2024
概括
不再推使用美特罗尼达来治疗克洛斯特里迪奥伊德困难感染 (CDI). 由于复发率较低,菲达克索米辛现在是首选药物,而万科米辛作为替代品,并且出现了复发性CDI的新选择.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 临床实践 临床实践
背景情况:
- 困难菌感染 (CDI) 是一个主要的全球健康问题,导致严重的疾病和死亡.
- 目前的治疗选择包括甲尼达,万科米辛和菲达克索米辛,甲尼达的疗效较低.
- 欧洲临床微生物学和传染病学会 (ESCMID) 在2021年更新了CDI管理指南.
研究的目的:
- 评估当前欧洲在管理Clostridioides difficile感染 (CDI) 的实践.
- 评估2021年ESCMID CDI管理指南的采用和实施情况.
- 识别欧洲各国对CDI治疗策略和处方前要求的差异.
主要方法:
- 一项调查于2022年11月进行,来自欧洲17个国家的64名受访者参与了调查.
- 该调查评估了国家CDI指导方针的存在以及纳入2021年ESCMID指导方针.
- 收集了关于第一线治疗选择,高风险患者使用药物以及处方前批准流程的数据.
主要成果:
- 范科米辛 (66%) 和菲达克索米辛 (47%) 是最常见的CDI第一线治疗方法,而甲尼达的使用却有所减少.
- 菲达克索米更常用于高风险患者.
- 对于比斯洛托克苏马布 (bezlotoxumab) 和便微生物群移植 (FMT) 等较新的药物,预处方批准是常见的.
结论:
- 欧洲CDI管理正在演变,从甲尼达转向fidaxomicin和vancomycin.
- 更新指南的实施正在取得进展,但实践中的差异和限制仍然存在.
- 新型疗法和FMT对复发性CDI具有前景,尽管它们的作用仍在评估中.
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