优化脓毒症早期抗生素治疗策略的研究进展  

Progress in Optimizing Antibiotic Treatment Strategies for Early Sepsis

作　　者：吴狄 刘善收 王倩梅 李俊杰 WU Di;LIU Shanshou;WANG Qianmei;LI Junjie(Department of Graduate Work,Xi'an Medical College,Xi'an 710000,Shaanxi China;Department of Emergency,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032,China)

机构地区：[1]西安医学院研究生工作部,西安710000 [2]空军军医大学第一附属医院急诊科,西安710032

出　　处：《临床误诊误治》2024年第15期95-100,共6页Clinical Misdiagnosis & Mistherapy

基　　金：空军军医大学临床研究项目(2023LC2335);西京医院医务人员培养助推项目(XJZT24CY22,XJZT24LY08)。

摘　　要：脓毒症是感染引起的宿主反应失调,导致危及生命的器官功能障碍,病死率较高。脓毒症治疗的关键在于抗生素的合理使用,包括及时性、精准性以及个体化治疗。本文系统查阅国内外关于脓毒症抗生素抗菌谱与治疗时机、不同感染部位常见病原菌与耐药性、抗生素治疗方案与不良反应的文献并进行综述,以提高临床医师早期选用抗生素的精准性:基于病原菌流行病学和药敏学特征合理地选用抗生素,结合药效学和药代学特点优化脓毒症早期抗生素治疗策略,改善患者预后。Sepsis is a host response disorder caused by infection that leads to life-threatening organ dysfunction with a high fatality rate.The key to sepsis treatment is the rational use of antibiotics,including timeliness,precision and individualized treatment.In this study,domestic and foreign literature on antibiotic antibacterial spectrum and treatment timing,common pathogens and drug resistance in different infection sites,antibiotic treatment plans and adverse reactions was systematically reviewed,so as to improve the accuracy of early antibiotic selection by clinicians:Based on the epidemiology and pharmacokinetic characteristics of pathogenic bacteria,antibiotics were selected reasonably,combined with pharmacodynamics and pharmacokinetic characteristics to optimize the early antibiotic treatment strategy for sepsis,and improve the prognosis of patients.

关 键 词：脓毒症 抗菌药 抗菌谱 微生物敏感性试验 耐药性 药代学 药效学 综述 

分 类 号：R631[医药卫生—外科学]