再次提出:在移植传染病中的抗微生物管理:更新和新的挑战
Helen Tsai1, Rachel Bartash1, Daniel Burack1
1Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Antimicrobial stewardship & healthcare epidemiology : ASHE
|January 18, 2024
概括
对移植患者来说,抗微生物药物管理至关重要,它解决了诸如发烧性中性质衰竭和多药耐药生物体等挑战. 这一审查更新了现有问题,并引入了新的管理问题,包括抗生素持续时间和过敏管理.
科学领域:
- 移植医学 移植医学
- 传染性疾病 传染性疾病
- 抗微生物药物管理委员会
背景情况:
- 固体器官和造血干细胞移植的进步改善了患者的治疗结果.
- 保持抗微生物药物的有效性对于预防移植受体感染和败血症至关重要.
- 抗菌药物管理对于安全和成功的移植手术至关重要.
研究的目的:
- 为移植患者提供已建立的抗微生物管理挑战的最新信息.
- 介绍和讨论移植独特的新出现的管理挑战.
- 突出移植抗菌药物管理的潜在解决方案和研究缺口.
主要方法:
- 审查当前的文献和关于移植中的抗菌药物管理的数据.
- 讨论之前发现的挑战:发烧性中性质不良症,Clostridioides difficile感染,无症状的细菌性尿.
- 探索新的挑战:抗微生物的持续时间,抗生素过敏,多药耐药生物体的殖民化和细胞巨乳病毒管理.
主要成果:
- 累积的数据支持"越短越好"和移植患者的抗生素过敏脱标.
- 多抗药生物体的殖民化影响了抗生素预防的决策.
- 细胞巨病毒的管理需要特定的抗病毒管理策略.
- 扩大抗菌药物管理干预措施被提出作为一个解决方案.
结论:
- 解决不断变化的抗微生物药物管理挑战对于移植患者护理至关重要.
- 需要进一步的研究来填补移植特异性抗菌药物管理方面的知识空白.
- 优化抗菌剂的使用可以提高固体器官和干细胞移植的安全性和有效性.
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