抗生素治疗多药耐药格拉姆阴性细菌感染的持续时间:基于证据的审查
Andrea Marino1, Egle Augello2,3, Carlo Maria Bellanca2,3,4
1Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, ARNAS Garibaldi Hospital, 95122 Catania, Italy.
International journal of molecular sciences
|July 29, 2025
概括
针对多抗药性格拉姆阴性细菌 (MDR-GNB) 感染的最佳抗生素持续时间尚不清楚. 有证据表明更短的课程存在,但对于复杂的MDR-GNB案例需要更多的研究.
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
- 抗微生物药物管理委员会
背景情况:
- 确定多抗药性格拉姆阴性细菌 (MDR-GNB) 感染的最佳抗生素持续时间具有挑战性.
- 将治疗疗效与副作用和抗药性风险之间的平衡至关重要.
研究的目的:
- 审查当前关于MDR-GNB感染抗生素持续时间的证据和指导方针.
- 识别知识缺口和未来研究领域.
主要方法:
- 对现有文献和临床指南进行叙述性审查.
- 专注于血液感染 (BSI),医院获得的/呼吸机相关的肺炎 (HAP/VAP),复杂的尿路感染 (CUTIs) 和腹内感染 (IAIs).
主要成果:
- 有限的数据指导了MDR-GNB的最佳持续时间,特别是对抗卡巴烯的肠道细菌 (CRE),难以治疗的 Pseudomonas aeruginosa (DTR-Pa) 和抗卡巴烯的 Acinetobacter baumannii (CRAB).
- 目前的指导方针缺乏关于治疗持续时间的具体建议.
- 一些研究表明,在特定情况下,更短的课程可能是不劣的,但往往排除了复杂的情况.
结论:
- 需要个性化治疗决策,考虑临床反应,患者因素和感染严重程度.
- 迫切需要进行随机对照试验,以确定挑战MDR-GNB感染的最佳持续时间.
- 临床医生必须平衡不确定性与密切监测和抗菌药物管理原则.
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