明智地使用抗生素。

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-09-21 DOI:10.1097/QCO.0000000000000973
Jae Jung, Francesca Cozzi, Graeme N Forrest
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引用次数: 0

摘要

综述的目的:这篇综述将描述较短的抗生素治疗、从静脉注射到口服治疗的早期转变以及人工智能在传染病中的作用。最近的发现:有证据表明,较短疗程的抗生素并不劣于标准的治疗持续时间。肠杆菌属菌血症已经证明了这一点,可以用7 治疗天数,社区获得性肺炎3例 天和呼吸机相关性肺炎仅7天 抗生素治疗天数。从静脉注射到口服治疗菌血症、心内膜炎、骨关节感染是安全有效的,可以减少线路并发症和成本。此外,对于清洁的外科手术,只需要一剂抗生素,但它应该是最有效的抗生素,即头孢唑林。这意味着避免使用克林霉素,尽可能消除青霉素过敏,以改善疗效。最后,人工智能在明智地使用抗生素方面的作用正在迅速显现,但仍处于早期阶段。总结:在明智地使用抗生素方面,靶向治疗,如治疗持续时间和从静脉抗生素治疗到口服的转变是唾手可得的成果。人工智能的未来可能会使这项工作自动化,这是令人兴奋的,但需要证明。视频摘要:http://links.lww.com/COID/A50.
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Using antibiotics wisely.

Purpose of review: This review will describe role of shorter antibiotic therapies, early switch from intravenous to oral therapy, and artificial intelligence in infectious diseases.

Recent findings: There is evidence that shorter courses of antibiotics are noninferior to standard durations of therapy. This has been demonstrated with Enterobacterales bacteremia that can be treated with 7 days of therapy, community acquired pneumonia with 3 days and ventilator associated pneumonia with just 7 days of antibiotic therapy. The conversion from intravenous to oral therapy in treating bacteremia, endocarditis and bone and joint infections is safe and effective and reduces line complications and costs. Also, for clean surgical procedures only one dose of antibiotic is needed, but it should be the most effective antibiotic which is cefazolin. This means avoiding clindamycin, removing penicillin allergies where possible for improved outcomes. Finally, the role of artificial intelligence to incorporate into using antibiotics wisely is rapidly emerging but is still in early stages.

Summary: In using antibiotics wisely, targeting such as durations of therapy and conversion from intravenous antibiotic therapy to oral are low hanging fruit. The future of artificial intelligence could automate a lot of this work and is exciting but needs to be proven.

Video abstract: http://links.lww.com/COID/A50.

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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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