抗生素治疗儿科呼吸机相关肺炎的持续时间
Aki Miyashita1, Hanako Funakoshi1, Meiwa Shibata1
1Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
概括
对儿科呼吸机相关肺炎 (VAP) 进行六至七天的抗生素疗程似乎是安全有效的. 儿童的结局与成人VAP治疗数据相似或更好.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
背景情况:
- 儿童呼吸机相关肺炎 (VAP) 的最佳抗生素持续时间尚未确立.
- 成人VAP指南建议使用七天的抗生素疗程.
- 这项研究侧重于儿科VAP管理和结果.
研究的目的:
- 描述儿科VAP的治疗和临床结果.
- 评估当前VAP儿童管理策略的有效性.
- 为了将儿科VAP结果与现有的成人数据进行比较.
主要方法:
- 在儿科重症监护病房 (PICU) 的回顾性队列研究.
- 包括从2016年4月到2023年6月被诊断患有VAP的18岁以下儿童 (CDC标准).
- 排除了患有并发感染或未接受过抗生素治疗的患者;收集了人口和微生物学的数据.
主要成果:
- 分析了90名儿科患者;中位数年龄为19个月.
- 黄金葡萄球菌 (Staphylococcus aureus) (28%) 和空气球菌 (Pseudomonas aeruginosa) (22%) 是常见的病原体.
- 平均抗生素持续时间为6天;7天和28天的死亡率分别为1%和6%,没有与VAP相关的死亡. 复发率为10%,为10%.
结论:
- 对儿科VAP的六到七天的抗生素治疗方案与有利的结果有关.
- 儿科VAP复发率和康复指标 (无通风,无PICU日) 与成人数据相比或优于.
- 目前对儿科VAP的抗生素治疗持续时间似乎充足.
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