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1、病情恶化还是痊愈回家优化医院感染的早期诊断与治疗GOHARDGOHOMEOptimisingtheearlydiagnosisandtreatmentofnosocomialinfections全球约12%－27%（英国）的ICU患者是因严重脓毒血症入院更多患者在ICU中获得严重脓毒血症（特别是复合外伤患者）抗生素研发面临停滞聪明的细菌有个魔球（杂交性、获取遗传物质）背景高效的广谱抗生素的广泛应用导致细菌耐药性增加我们必须谨慎而合理地使用抗生素！初始治疗正确敏感性的地区差异降阶梯治疗抗生素治疗疗程总结及要点纲要Garnacho-MonteroJ,Garcia-GarmendiaJL,Bar
2、rero-AlmodovarA,Jimenez-JimenezFJ,Perez-ParedesC,Ortiz-LeybaC.Impactofadequateantibiotictherapyontheoutcomeofpatientsadmittedtotheintensivecareunitwithsepsis.CritCareMed2003;31:2742-2751.KollefMH,ShermanG,WardS,FraserVJ.Inadequateantimicrobialtreatmentofinfections:ariskfactorforhospitalmortalityam
3、ongcriticallyillpatients.Chest1999;115:462-474.RelloJ,GallegoM,MariscalD,SonoraR,VallesJ.Thevalueofroutinemicrobialinvestigationinventilator-associatedpneumonia.AmJRespirCritCareMed1997;156:196-200.IreguiM,WardS,ShermanG,FraserVJ,KollefMH.Clinicalimportanceofdelaysintheinitiationofappropriateantib
4、iotictreatmentforventilator-associatedpneumonia.Chest2002;122:262-268.LunaCM,VujacichP,NiedermanMS,VayC,GherardiC,MateraJ,JollyEC.ImpactofBALdataonthetherapyandoutcomeofventilator-associatedpneumonia.Chest1997;111:676-685.LeiboviciL,DruckerM,KonigsbergerHetal.Septicshockinbacteremicpatients:riskfa
5、ctors,featuresandprognosis.ScandJInfectDis1997;29:71-75.VallesJ,RelloJ,OchagaviaA,GarnachoJ,AlcalaMA.Community-acquiredbloodstreaminfectionincriticallyilladultpatients:impactofshockandinappropriateantibiotictherapyonsurvival.Chest2003;123:1615-1624.IbrahimEH,ShermanG,WardS,FraserVJ,KollefMH.Theinf
6、luenceofinadequateantimicrobialtreatmentofbloodstreaminfectionsonpatientoutcomesintheICUsetting.Chest2000;118:146-155.Alvarez-LermaF.Modificationofempiricantibiotictreatmentinpatientswithpneumoniaacquiredintheintensivecareunit.ICU-AcquiredPneumoniaStudyGroup.IntensiveCareMed1996;22:387-394.MacArth
7、urRD,MillerM,AlbertsonTetal.Adequacyofearlyempiricantibiotictreatmentandsurvivalinseveresepsis:ExperiencefromtheMONARCSTrial.ClinInfectDis2003;38:284-288.HarbarthS,GarbinoJ,PuginJetal.Inappropriateinitialantimicr
