在生命末期使用抗生素:当前的做法和优化方法
Minji Kang1, Winnie S Wang2, Zieanna Chang2
1Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
The American journal of hospice & palliative care
|July 20, 2024
概括
在生命终端 (EOL) 护理中使用抗生素往往是过度的,因为指南有限. 重新评估抗生素决定,专注于患者的益处,并探索非抗生素症状管理对于适当的EOL护理至关重要.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 传染病管理 传染病管理
- 医学伦理 医学伦理
背景情况:
- 感染是终身护理 (EOL) 的常见并发症.
- 临床医生缺乏针对EOL环境中的抗生素决策的具体指导,导致过度使用.
- 抗生素用于缓解EOL的症状是常见的,但通常是无效的,除了尿路感染.
研究的目的:
- 分析当前在终身护理中使用抗生素的做法.
- 强调需要重新评估EOL中的抗生素决策.
- 倡导一种更有判断力和以患者为中心的抗生素处方方法.
主要方法:
- 关于抗生素疗效和EOL护理结果的文献综述.
- 对EOL抗生素使用的临床指南和专家意见的分析.
- 讨论在为绝症患者开抗生素处方时的伦理考虑.
主要成果:
- 当预后为几天到几周时,抗生素提供了有限的生存益处.
- 抗生素对症状的改善是最小的,除了像尿路感染这样的特定感染.
- 目前在EOL护理中广泛使用抗生素需要进行批判性重新评估.
结论:
- 在EOL中使用抗生素应保留在具有明显患者益处的场景中,考虑感染类型,预后和患者偏好.
- 在怀疑感染时,将非抗生素症状管理纳入护理计划是必不可少的.
- 在护理规划期间讨论和记录抗生素偏好对于明智的决策是有益的.
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