我如何在注射毒品的人中管理严重的细菌感染
Andrew J Stewardson1, Joshua S Davis2, Adrian J Dunlop3
1Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, Melbourne, VIC, Australia.
概括
在注射药物的人中,管理严重的细菌感染需要以患者为中心,减少危害的方法. 需要对最佳抗生素策略和共同设计的试验进行更多的研究,以改善对这一脆弱人群的护理.
科学领域:
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
- 临床医学 临床医学
背景情况:
- 注射药物使用是严重细菌感染的重要危险因素.
- 有限的高质量的证据存在,以指导这种人群的临床管理.
- 管理方面的挑战包括不信任,耻辱和患者优先事项的竞争.
研究的目的:
- 审查注射毒品的人中严重感染的管理.
- 作为一个说明,使用黄金葡萄球菌 (Staphylococcus aureus) 血液感染的临床场景.
- 突出降低危害和以患者为中心的护理策略.
主要方法:
- 进行了有关主题的文献搜索.
- 由于缺乏随机试验,建议是基于观察研究,推断和专家意见.
- 讨论涵盖了败血症管理,手术指示,物质依赖,抗生素管理,健康促进和感染预防.
主要成果:
- 在这种人群中,具体的管理策略的证据很少.
- 建议采用多学科,创伤相关的方法.
- 患者参与至关重要,强调减少危害和以患者为中心的护理.
结论:
- 建议采用多学科,创伤相关的方法来管理注射毒品的人的严重细菌感染.
- 与社区共同设计的实用试验对于制定基于证据的指导方针至关重要.
- 需要进一步研究各种抗生素施用策略的比较有效性,包括住院静脉注射,早期口服切换,门诊亲肠道治疗和长效药物.
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