针对肝硬化患者自发感染的基于证据的经验性抗生素建议
Melisa Dirchwolf1, Gonzalo Gomez Perdiguero2, Fernando Cairo3
1Liver Unit, Hospital Privado de Rosario, Presidente Roca 2440, CP 200, Santa Fe, Argentina.
概括
目前的抗生素指南对肝硬化患者的自发细菌感染提供了不充分的经验覆盖. 当地数据对于更新治疗建议至关重要,以改善患者的治疗结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
背景情况:
- 越来越多的抗药性感染需要评估经验性抗生素治疗的有效性.
- 自发性细菌感染 (SBI) 是肝硬化患者的重要并发症.
研究的目的:
- 在肝硬化患者中确定SBI的抗生素敏感性模式.
- 评估当前欧洲和美国对SBI实证抗生素治疗指南的充分性.
主要方法:
- 对阿根廷和乌拉圭的前数据进行横截面分析.
- 在229名肝硬化患者中对培养阳性SBI的评估.
- 观察到的敏感性与推的经验性抗生素覆盖率的比较.
主要成果:
- 对于社区收购的SBI,Ceftriaxone提供了70%的覆盖率,而cefepime提供了74%的覆盖率.
- 埃尔塔尼姆对医院SBI的覆盖率为56%,梅罗尼姆/伊米尼姆达到73%.
- 梅罗佩内姆/伊米佩内姆加上万科米辛的覆盖率超过了与医疗保健相关的/非社会性SBI的85%.
结论:
- 目前的经验性抗生素指南显示,在特定情景下,肝硬化患者的SBI覆盖范围不足.
- 当地流行病学数据对于开发有效的,基于指南的经验性治疗策略至关重要.
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