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在患有血液感染的患者中,抗生素治疗时间为7天而不是14天

, Nick Daneman¹, Asgar Rishu²

¹Division of Infectious Diseases, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto.

The New England journal of medicine

|November 20, 2024

概括

对于血液感染,抗生素7天疗程与14天疗程同样有效. 这种更短的持续时间可以减少治疗时间,而不会影响患者的生存结果.

科学领域:

传染性疾病传染性疾病
临床微生物学临床微生物学
药理学药理学是指药理学的学科.

背景情况:

血流感染 (BSI) 对患者的发病率和死亡率构成重大风险.
对BSI的最佳抗生素治疗持续时间仍然是临床不确定性的领域.

研究的目的:

为了确定7天的抗生素治疗疗程是否与血液感染住院患者的14天疗程相比,不劣.

主要方法:

一个多中心的非劣势随机试验,涉及3608名患有血液感染的住院患者.
患者被分配接受7天或14天的抗生素治疗,而抗生素的选择由治疗医生决定.
排除标准包括严重的免疫抑制,特定的感染焦点,可疑的污染物培养和黄金葡萄球菌感染.

主要成果:

90天全因死亡率在7天组为14.5%,在14天组为16.1%,表明较短持续时间的非劣势 (差异:-1.6个百分点;95.7% CI,-4.0至0.8).
每个方案的分析也支持了7天治疗持续时间的非劣势性.
在二次结果和预定义的子组中,研究结果一致.

结论:

对于被诊断患有血液感染的住院患者,七天的抗生素治疗与14天的治疗无差.
这种更短的持续时间为管理常见的血液感染提供了安全有效的替代方案.

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