基于证据的方法治疗慢性抗生素耐药性炎:一篇评论
Andrew T Weber1, Gary R Lichtenstein
1Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
慢性抗生素耐药性囊炎的管理具有挑战性. 生物疗法显示出对症状控制的希望,并为难以治疗的病例提供一种不需要使用类固醇的替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 炎症性肠道疾病是什么
- 外科手术的结果
背景情况:
- 慢性抗生素耐药性囊炎 (CARP) 在IPAA的恢复性结肠切除术后构成了重大治疗挑战.
- CARP是由持续的囊炎症状定义的,这些症状对标准的抗生素治疗没有反应.
研究的目的:
- 提供关于管理CARP的当前证据的全面叙事审查.
- 总结CARP的各种治疗干预措施的有效性和局限性.
主要方法:
- 在PubMed的系统文献搜索中,寻找有关CARP管理的研究.
- 包括在过去3-5年内发表的案例系列,队列研究,RCT和元分析.
- 对药理学和选择非药理学干预措施的评估.
主要成果:
- 梅萨拉胺可以缓解症状,但不能改善生活质量.
- 在小组患者中,布德尼德的缓解率很高.
- 抗TNF疗法和vedolizumab在临床和内镜结局方面表现出有效性.
- 乌斯特基努马布显示了令人鼓舞的临床反应.
- 高压氧和便微生物群移植的数据有限,可访问性问题也存在.
结论:
- 生物疗法是对耐火性CARP的有效的类固醇节省选择.
- 对于非药物疗法,如高压氧和便微生物群移植等,需要进一步的研究.
- 目前的证据主要基于小型的回顾性研究,强调需要进行更大规模的试验.
更多相关视频
03:25Author Spotlight: Exploring Non-Pharmacological Therapies for Chronic Respiratory Diseases — Linking Intestinal Microbiome Insights to COPD Treatment
Published on: December 27, 2024
03:53Growing a Cystic Fibrosis-Relevant Polymicrobial Biofilm to Probe Community Phenotypes
Published on: April 19, 2024
相关概念视频
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Treating Helicobacter pylori in Peptic Ulcers: Antimicrobial Therapy
Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
Pleural Effusion II: Symptoms and Management
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
