胸部放射成像结果与社区获得性肺炎的抗生素启动之间的关系 常务医生对社区获得性肺炎的管理
Juliette Pinot1,2, Serge Gilberg2, Cédric Laouénan3,4
1Université Paris Cité and Université Sorbonne Paris Nord, INSERM, IAME, Paris, France juliette.pinot@u-paris.fr.
Annals of family medicine
|November 25, 2024
概括
一般医生开始为几乎所有疑似社区获得性肺炎 (CAP) 和阳性胸部X射线图 (CRs) 的患者提供抗生素. 然而,抗生素也经常用于负CRs,突出需要更明确的指导方针.
科学领域:
- 一般实践一般实践
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 社区获得性肺炎 (CAP) 的诊断通常依赖于临床症状和胸部放射 (CR) 发现.
- 对于疑似CAP的初级保健中抗生素处方做法需要进一步调查.
研究的目的:
- 根据CR结果,分析全科医生对疑似CAP患者的抗生素启动情况.
主要方法:
- 在2017年11月至2019年12月期间,在法国的一般实践中进行了前性横截面研究.
- 包括在CR后临床怀疑CAP的成年患者,放射图被分类为CAP阳性或阴性.
- 根据CR结果分析了患者的特征和抗生素启动.
主要成果:
- 在259名患者中,有144人 (55.6%) 呈CRs阳性. 99.3%的阳性CR患者和68.7%的阴性CR患者 (P < .001) 开始服用抗生素.
- 阳性CRs患者在临床上更严重,症状持续时间更长.
- 在接受或不接受抗生素的CR阴性患者中没有发现临床相关的差异化因素.
结论:
- 一般医生始终使用积极的CR结果来指导疑似CAP的抗生素启动.
- 负CR结果对抗生素处方决定的影响较小.
- 需要进一步澄清,以管理缺乏放射学确认的疑似CAP病例.
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