Pranita D Tamma, Emily L Heil, Julie Ann Justo, Amy J Mathers, Michael J Satlin, Robert A Bonomo
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引用次数: 0
摘要
背景：美国传染病学会 (IDSA) 致力于为抗菌药物耐药性 (AMR) 感染的治疗提供最新指导。本指导文件重点关注由产扩展谱β-内酰胺酶肠杆菌属（ESBL-E）、产 AmpC β-内酰胺酶肠杆菌属（AmpC-E）、耐碳青霉烯类肠杆菌属（CRE）、难治性铜绿假单胞菌（DTR 铜绿假单胞菌）、耐碳青霉烯类鲍曼不动杆菌（CRAB）和嗜麦芽血单胞菌引起的感染。本更新文件取代了之前版本的指导文件：由六位在抗菌药物耐药性感染管理方面具有专长的传染病专家组成的专家小组就 ESBL-E、AmpC-E、CRE、DTR 铜绿假单胞菌、CRAB 和嗜麦芽单胞菌引起的感染的治疗提出了问题。由于 AMR 的流行病学和国际上特定抗感染药物的供应情况存在差异，本文件重点介绍了美国 AMR 感染的治疗方法：结果：假定致病菌已经确定，抗生素敏感性结果已知，本文提供了首选和备选的治疗方法建议，并附有相应的理由。简要讨论了经验性治疗方法、向口服治疗过渡、治疗持续时间以及其他管理注意事项。建议的方法适用于成人和儿童，但建议的抗生素剂量仅适用于成人：AMR领域是一个高度动态的领域。建议在治疗 AMR 感染时咨询传染病专家。本文件截至 2023 年 12 月 31 日，并将定期更新。本文件的最新版本（包括出版日期）可在 www.idsociety.org/practice-guideline/amr-guidance/ 网站上查阅。
Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.
Background: The Infectious Diseases Society of America (IDSA) is committed to providing up-to-date guidance on the treatment of antimicrobial-resistant (AMR) infections. This guidance document focuses on infections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E), AmpC β- lactamase-producing Enterobacterales (AmpC-E), carbapenem-resistant Enterobacterales (CRE), Pseudomonas aeruginosa with difficult-to-treat resistance (DTR P. aeruginosa), carbapenem-resistant Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia. This updated document replaces previous versions of the guidance document.
Methods: A panel of six infectious diseases specialists with expertise in managing antimicrobial- resistant infections formulated questions about the treatment of infections caused by ESBL-E, AmpC-E, CRE, DTR P. aeruginosa, CRAB, and S. maltophilia. Because of differences in the epidemiology of AMR and availability of specific anti-infectives internationally, this document focuses on the treatment of AMR infections in the United States.
Results: Preferred and alternative suggested treatment approaches are provided with accompanying rationales, assuming the causative organism has been identified and antibiotic susceptibility results are known. Approaches to empiric treatment, transitioning to oral therapy, duration of therapy, and other management considerations are discussed briefly. Suggested approaches apply for both adult and pediatric populations, although suggested antibiotic dosages are provided only for adults.
Conclusions: The field of AMR is highly dynamic. Consultation with an infectious diseases specialist is recommended for the treatment of AMR infections. This document is current as of December 31, 2023 and will be updated periodically. The most current version of this document, including date of publication, is available at www.idsociety.org/practice-guideline/amr-guidance/.
期刊介绍：
Clinical Infectious Diseases (CID) is dedicated to publishing original research, reviews, guidelines, and perspectives with the potential to reshape clinical practice, providing clinicians with valuable insights for patient care. CID comprehensively addresses the clinical presentation, diagnosis, treatment, and prevention of a wide spectrum of infectious diseases. The journal places a high priority on the assessment of current and innovative treatments, microbiology, immunology, and policies, ensuring relevance to patient care in its commitment to advancing the field of infectious diseases.
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