社区获得性肺炎初始治疗失败的评估与处理进展

社区获得性肺炎(community-acquired pneumonia,CAP)具有高发病率和高病死率的特点,危害严重。CAP初始治疗的成败很大程度上决定着患者疾病转归。在确立CAP临床诊断并安排合理病原学检查及标本采样后,需根据患者年龄、基础疾病、临床特点等分析患者病原学特征,及时实施初始经验性抗感染治疗。虽然我国和世界众多国家都制定了CAP诊疗指南,但CAP的初始治疗失败率高仍是不可回避的问题。本文对CAP初始治疗失败的评估与处理进展进行综述,以期为CAP的临床诊治提供帮助。

Development of evaluation and management of initial treatment failure in the patients with community-acquired pneumonia

Community-acquired pneumonia(CAP)is characterized by morbidity and mortality globally.The effectiveness of initial treatment is the key factor leading to successful outcome.The initial anti-infection treatment should be administrated timely once the diagnosis of CAP is established and the microbiological examinations are taken.The anti-infective agents chosen for initial treatment should be based on the patients′age,underlying diseases,clinical characteristics.Although various guidelines in the diagnosis and treatment of CAP has been published in China and other countries,the ratio of initial treatment failure is still high.In this article,we summarized the factors leading to initial treatment failure of CAP and recent clinical studies on the relevance of anti-infective therapy and initial treatment failure,aiming to improve the successful rate of initial treatment of CAP in clinical settings.