针对创伤患者早期呼吸机相关肺炎的短期抗生素治疗
Bethany R Shoulders1, Anne-Marie Fassler2, Kelly L Maguigan3
1Department of Pharmacy Education and Practice, University of Florida College of Pharmacy, Gainesville, Florida, USA.
创伤患者早期呼吸器相关肺炎 (VAP) 的较短抗生素疗程可以减少药物暴露,而不会增加肺炎复发. 这种为期五天的疗法是安全有效的.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 创伤外科 手术 创伤外科
背景情况:
- 在创伤患者中,呼吸机相关肺炎 (VAP) 增加了多药耐药性风险.
- 早期VAP治疗持续时间是抗生素管理的潜在目标.
- 优化抗生素持续时间可能会降低耐药性,而不会影响患者的治疗结果.
研究的目的:
- 在创伤患者中评估早期细菌VAP缩短 (5天) 抗生素疗程的疗效和安全性.
- 为了比较短时间和标准时间的抗生素治疗之间的肺炎复发率和其他临床结果.
主要方法:
- 在一级创伤中心进行回顾性队列研究.
- 包括成年创伤患者与经过支气管支气管洗证明的早期细菌VAP.
- 将患者分为两层,分为短期 (4-5天) 和标准期 (7-8天) 的抗生素治疗组.
主要成果:
- 在短时间 (26%) 和标准时间 (20%) 队列之间,复发性肺炎的发生率没有显著差异.
- 短期治疗组的患者年龄较大,伤害严重程度得分较低.
- 在二次结果 (包括死亡率和停留时间) 中没有发现显著差异.
结论:
- 创伤患者早期VAP的五天抗生素疗程有效降低了抗生素暴露.
- 缩短抗生素治疗不会对肺炎复发或其他关键临床结果产生不利影响.
- 这种方法支持对重症创伤患者的抗生素管理.
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