在慢性儿科肺病中预防性抗生素:平衡益处,耐药性和未来护理模型
Isaac Martin1,2, Valerie Waters2,3
1Division of Paediatric Respiratory Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON , Canada.
预防性抗生素可以通过减少感染和炎症来帮助患有慢性肺部疾病的儿童,例如囊性纤维化. 然而,它们的使用需要仔细考虑风险,益处和抗菌药物管理.
科学领域:
- 儿科肺病学 儿科肺病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有慢性肺部疾病的儿童,如囊性纤维化 (CF),非CF支气管炎 (NCFB),慢性性肺部疾病 (CSLD) 和初级纤维动力障碍 (PCD) 患有复发性感染和持续的呼吸道炎症.
- 这种慢性感染-炎症循环会导致逐渐的肺损伤.
研究的目的:
- 审查当前关于预防性抗生素在儿科慢性肺病中的使用证据.
- 评估宏类和非宏类预防策略的疗效和安全性.
- 为预防性抗生素的选择性和明智使用提供框架.
主要方法:
- 使用PubMed进行了有针对性的文献搜索.
- 包括临床试验,观察性研究和指导方针建议.
- 搜索的重点是18岁以下儿童的预防性抗生素策略,疾病特异性结果,抗菌素耐药性和管理.
主要成果:
- 支持抗生素预防的证据因具体的疾病和临床情况而异.
- 抗生素耐药性和管理是预防性抗生素使用的关键考虑因素.
- 个性化风险效益评估对于确定适当使用至关重要.
结论:
- 提出了一个针对选择性,时间有限的预防性抗生素使用的框架.
- 该框架强调个性化的评估,定期的疗效再评估,以及与抗菌药物管理原则的整合.
- 优化预防性抗生素策略对于管理慢性儿科肺部疾病至关重要.
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