与冲突和灾难有关的严重烧伤:对抗微生物药物决策的挑战性环境
Scott Jc Pallett1, Rakhee Mistry2, Zoe L Lambert3
1Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital, Birmingham, UK; Clinical Infection Department, Chelsea and Westminster Hospital NHS Foundation Trust, SW10 9NH London, UK.
The Journal of infection
|July 10, 2024
概括
冲突地区的严重烧伤造成的伤害带来了独特的挑战. 本次审查审查了系统性抗生素的使用情况,强调在抗菌素耐药性问题中需要基于证据的指导方针.
科学领域:
- 冲突医学是一种冲突医学.
- 传染病管理 传染病管理
- 烧伤护理研究研究
背景情况:
- 严重的烧伤在与冲突有关的伤害中很常见,导致高死亡率.
- 冲突环境为严重烧伤带来独特的后勤,诊断和治疗挑战.
- 更广泛的冲突与局部抗菌素耐药性增加有关.
研究的目的:
- 在过去十年中,审查有关在冲突环境中治疗严重烧伤的全身抗菌性抗生素使用的文献.
- 由于有限的可用数据,提供专家共识讨论.
- 解决冲突环境对抗微生物药物决策的影响.
主要方法:
- 针对过去10年发表的研究的有针对性的文献审查.
- 基于经过审查的文献和临床经验的专家共识讨论.
- 分析冲突地区的后勤,诊断和治疗选择方面的挑战.
主要成果:
- 国际指导方针一般不建议常规预防性系统性抗生素用于严重烧伤.
- 冲突环境和潜在的多创伤显著影响了抗菌素使用决策.
- 在这种特定情况下,关于全身抗生素的有效性和最佳使用的数据有限.
结论:
- 需要一个务实的方法来平衡抗微生物选择性压力与在冲突环境中实现现实的获取.
- 进一步的研究对于开发一个强大的证据基础来管理冲突地区的严重烧伤至关重要.
- 在受冲突影响地区的抗微生物药物管理需要针对性战略,考虑到独特的挑战.
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