在肝硬化患者中重新考虑自发细菌性腹膜炎的抗生素预防:首先,不要伤害
J Daniel Markley1,2, Jasmohan S Bajaj3
1Division of Infectious Diseases, Virginia Commonwealth University, Richmond, Virginia, USA.
肝硬化患者自发性细菌性腹膜炎 (SBPPr) 的抗生素预防缺乏确的证据,可能会造成伤害. 由于对抗微生物药物耐药性的担忧,重新考虑这种长期的做法至关重要.
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
- 抗微生物药物管理委员会
背景情况:
- 自上世纪90年代以来,自发性细菌性腹膜炎 (SBPPr) 的抗生素预防是肝硬化患者的标准护理.
- 主要胃肠道学会目前的建议支持SBPPr.
- 对SBPPr的证据基础较弱,没有明确的死亡益处.
研究的目的:
- 评估目前支持SBPPr在肝硬化患者中的证据.
- 讨论SBPPr.的意外后果和潜在危害.
- 倡导对SBPPr战略进行协同重新评估.
主要方法:
- 审查关于SBPPr在肝硬化中的现有文献.
- 对SBPPr.的益处与危害的分析.
- 考虑抗微生物药物耐药性和管理的影响.
主要成果:
- 支持SBPPr的证据有限,并没有显示出明显的死亡益处.
- 在患者和人口层面上,SBPPr具有重大意想不到的后果.
- 新出现的证据表明,SBPPr可能会造成伤害.
结论:
- 长期以来在肝硬化中使用SBPPr的做法需要紧急重新评估.
- 传染病,抗菌药物管理和肝病学之间的合作是必不可少的.
- 在抗微生物药物耐药性时代,需要对SBPPr采取更新的,连贯的方法.
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