在中性衰竭患者中进行抗菌预防的共识指南
Julian Lindsay1,2, Daniel Yeoh1,3, Benjamin W Teh1,4
1National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Internal medicine journal
|January 11, 2026
概括
不建议使用常规预防性抗生素治疗中性质减退症. 抗菌素耐药性和微生物组破坏的风险超过了癌症患者的益处,特别是改善了发烧管理.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 自2011年以来,预防性抗生素在中性衰竭患者中的使用一直在争论中.
- 癌症疗法已经发展,包括向疗法和免疫疗法,改变风险人群.
- 对微生物组在治疗反应和抗生素耐药性中的作用的理解越来越大.
研究的目的:
- 对接受癌症治疗的中性衰竭成人和儿童的抗菌预防的最新证据进行审查.
- 为澳大利亚和新西兰的医疗保健机构提供最新的建议.
- 在不断发展的医学知识和患者群体的背景下,评估抗生素预防的益处和危害.
主要方法:
- 对中性衰竭癌症患者的抗菌预防现有证据的系统审查.
- 对益处 (减少感染) 与危害 (抗菌素耐药性,不良影响,微生物组破坏) 的评估.
- 考虑当前的澳大利亚和新西兰医疗保健背景和改善败血症途径管理.
主要成果:
- 在大多数情况下,抗生素预防的危害 (耐药性,副作用,微生物组破坏) 超过了益处.
- 在审查的证据中,抗生素预防没有证明死亡率有好处.
- 通过败血症途径改善中性衰竭发烧的管理,减少了对常规预防的需要.
结论:
- 在澳大利亚和新西兰,对中性衰竭癌症患者一般不建议使用抗菌预防.
- 增加抗微生物药物耐药性和不良影响的可能性是一个重大问题.
- 应继续关注基于证据的中性衰竭发烧管理和明智的抗生素使用.
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