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关于报告抗生素过敏的评估和管理的ESCMID临床指南
Oana Joean1, Kevin Sermet2, Liat Ashkenazi-Hoffnung3
1Institute for Infectious Disease and Infection Control, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.
概括
错误标记的抗生素过敏导致抗菌素耐药性. 本指南提供基于证据的建议,用于评估和管理报告的抗生素过敏,以改善患者的治疗结果和抗菌药物管理.
科学领域:
- 临床微生物学 临床微生物学
- 传染性疾病 传染性疾病
- 过敏和免疫学 过敏和免疫学
背景情况:
- 抗生素过敏经常被记录在案,但真正的过敏症只影响5-10%的病例.
- 错误标记的抗生素过敏会导致抗菌素耐药性 (AMR) 通过低于最佳的处方和增加的广谱药物的使用.
研究的目的:
- 为报告抗生素过敏患者的临床评估和管理提供基于证据的建议.
- 在医疗保健机构协调非过敏症临床医生的实践.
主要方法:
- 由一个多学科小组使用修改后的 GRADE-ADOLOPMENT 过程开发.
- 对指导方针和初级研究 (2015-2024) 的系统文献搜索.
- 通过共识制定的建议,得到 ≥80% 的小组成员的同意.
主要成果:
- 建议进行结构化的临床评估,以根据指数反应特征评估报告的抗生素过敏.
- 直接取消标签或控制药物挑战是适合低概率的过敏病例.
- 建议支持改善个体患者的治疗结果和抗微生物药物管理目标.
结论:
- 结构化的评估和适当的取消标签或药物挑战可以准确地评估抗生素过敏.
- 根据过敏评估进行谨慎的处方实践对于打击AMR至关重要.
- 该指南旨在加强患者护理,并加强抗微生物药物管理工作.
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