感染性结核性胰腺炎的抗微生物疗法:微生物学,抗微生物耐药性和药理动力学
Hannah S Pauw1,2, Rolf Schwarz1,2, Astrid Beij3,4
1Department of Surgery, St.Antonius Hospital, Nieuwegein, the Netherlands.
受感染的胰腺亡,急性胰腺炎的严重并发症,需要谨慎的抗微生物治疗. 目前的证据表明,非碳烯胺β-乳酸盐可能有效,但需要更多的研究.
科学领域:
- 胃肠病学 胃肠病学
- 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:
- 急性胰腺炎是住院的常见原因,并导致严重的传染性并发症.
- 感染性胰腺亡 (IPN) 影响了30%的亡性胰腺炎病例,死亡率为15-35%.
- 在急性胰腺炎患者中,胰腺外感染也很常见.
研究的目的:
- 审查目前针对IPN的抗微生物治疗策略.
- 强调IPN治疗的微生物学和药理动力学.
- 讨论在IPN中管理耐药病原体的新兴趋势.
主要方法:
- 关于IPN抗菌疗法的当前前前景的文献综述.
- 微生物学数据和药理动力学研究的分析.
- 关于预防和治疗抗生素使用的证据的评估.
主要成果:
- 在IPN中占主导地位的病原体是肠道格拉姆阴性细菌,Enterococci和Candida物种.
- 由于长时间住院和抗生素暴露,抗菌素耐药性正在增加.
- 预防性抗生素在预防感染并发症方面并不有效.
- 非碳胺β-乳酸盐 (例如,皮佩拉西林-塔扎巴克坦,塞菲皮姆) 可能为IPN治疗提供足够的组织透.
结论:
- 针对IPN的抗菌疗法应考虑不断变化的微生物环境和药物动力学特性.
- 通过延长输液给药的非碳烯β-乳酸显示出有前途.
- 进一步对临床终点进行比较性疗效研究对于优化IPN治疗策略至关重要.
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