antibiotic lock versus systemic antibiotic in catheter related infections in immunocompromised pediatric patients课件

《antibiotic lock versus systemic antibiotic in catheter related infections in immunocompromised pediatric patients课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、Antibioticlockversussystemicantibioticsforcatheterrelatedinfectionsinimmunocompromisedpediatricpatients.EwelinaMamcarzM.D.,Divya-DeviJoshiM.D.ObjectivesDescribeindicationsforsystemicantibioticsversusantibioticlocktherapyEvaluatetypeofantibioticandtreatmentdurationforantibioticlockTimingofthea

2、ntibioticlock:early/lateAntibioticlockaspreventionofcatheterassociatedbacteremiaBackground:CatheterrelatedinfectionsLeadingcauseofmorbidityandmortalityincriticallyillhospitalizedpatientsOrganisms:Coagulase–negativestaphylococciStaphylococcusaureusGram-negativebacteriaCandidassp.Sourcesofinfec

3、tionColonizationfromtheskinIntraluminal/hubcontaminationHematologicseedingClinicalevaluation-CRILocalinflammationSepsisBloodcultureCatheterdysfunctionRapidimprovementfollowingcatheterremovalTreatmentTypeofdeviceInfectingpathogensPresenceofalternativevenousaccesssitesDurationofanticipatedneedf

4、oraccessTreatmentCatheterremovalSystemicantibioticsAntibioticlocktherapy(ALT)-littleevidencetosupportrecommendationDataGuidelinesfromtheInfectiousDiseasesSocietyofAmerica(IDSA):CRIdocumented,pathogenidentified-narrowspectrumsystemicabxandconsiderALTOnderatal:timingofantbclocks:ALTmoreeffectiv

5、eearlyintherapy,diminishedneedforcatheterremovalPervezatal:ALTforpreventionofCRI:decreasedincidenceofCRI,improvedsurvivalofcathetersAntibioticlockFirstpublication1988-MessingetalHigherconcentration,longerdurationofactivityattheinfectedsitewithoutpotentialside-effectsofsystemicexposureConcentr

6、ationandintra-luminaldwelltime:lackofevidencebasedrecommendationsLackoffirmrecommendationsforindividualpatientsImmunocompromisedpopulationPathogenesisofCRIcomplicatedVirulenceofthepathogensvariableHostfactorsnotwelldefinedLackofdiversitybetweenstudiedpopulationsAbsenceofcompellingclinicaldata

7、toformrecommendationsDataUncomplicatedcatheter-relatedbacteremias:InfectiousDiseaseSocietyofAmerica–systemicantibiotics(7days)+ALT(14days)Local,systemic,extra-luminalCRI–ALTshouldbecombinedwithsystemictreatmentforatleast72hoursDataSearchstrat