[缩短抗菌治疗时间]。

La Revue du praticien Pub Date : 2024-10-01
Aurélien Dinh, Bernard Castan
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引用次数: 0

摘要

缩短抗菌治疗时间。抗生素治疗持续时间是当前临床研究的一个重要领域。事实上,在细菌病变期间缩短抗生素疗程有几个好处:减少个人和集体抗药性的产生,降低成本、不良反应和对环境的影响。然而,要正确评估抗生素对个人预后的影响,还需要进行严格的调查。近年来,几项随机试验验证了针对常见细菌性病症的短期抗生素治疗:单纯急性肾盂肾炎 5 天,男性非发热性尿路感染 7 天,急性细菌性肺炎 3 至 5 天,化脓性脊柱盘炎 6 周。然而,有些时间似乎无法压缩,并且/或者需要因人而异:发热性男性尿路感染为 14 天,骨关节假体感染为 12 周。有必要将抗生素治疗的持续时间缩短至必要的最短时间,并对个性化的持续时间进行评估,特别是要考虑到免疫力低下的患者,他们往往被排除在试验之外。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Shortened antimicrobial therapy duration].

SHORTENED ANTIMICROBIAL THERAPY DURATION. Antibiotic treatment durations represent an important field of current clinical research. Indeed, shortening antibiotic duration during bacterial pathologies has several advantages: reducing the emergence of resistance on an individual and collective scale, reducing costs, adverse effects and the environmental impact. However, a rigorous investigation is necessary to properly assess the absence of impact on the individual prognosis. In recent years, several randomized trials have made it possible to validate short durations of antibiotic therapy for frequent bacterial pathologies: 5 days during simple acute pyelonephritis, 7 days for non-febrile urinary tract infections in men, 3 to 5 days during acute bacterial pneumonia, 6 weeks for pyogenic spondylodiscitis. However, some durations seem incompressible and/or require individualization: 14 days for febrile male urinary tract infections, 12 weeks for infections on osteoarticular prostheses. It is necessary to reduce the duration of antibiotic treatment to the minimum necessary and to evaluate personalized durations taking into account, in particular, immunocompromised patients who are often excluded from trials.

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