临床常用四环素类药物合理应用多学科专家共识

Multidisciplinary expert consensus on the rational use of tetracyclines commonly used in clinical practice

近年来随着新检出病原体的出现和细菌耐药性的增加,感染性疾病的诊断和治疗面临着严峻挑战。四环素类药物在临床应用广泛,药物品种也在不断更新,我国尚缺乏四环素类药物临床合理应用的指导性文件,部分医务人员对其药学特点和临床应用时机及用法存在疑惑。为进一步规范四环素类药物的临床应用,为各级医疗机构医务人员提供专业的循证医学建议,中华预防医学会医院感染控制分会和中国药理学会临床药理分会牵头,组织感染科、呼吸科、重症医学科、急诊科、感染控制中心、药学部等多个学科领域专家经过共识会议制订了临床常用四环素类药物合理应用多学科专家共识。本专家共识以国内常用的四环素类药物的药学特性为基础,以四环素类药物作用机制和耐药现状为依据,结合感染部位、病原体特点及细菌耐药性,关注特殊人群和超说明书用药,整合国内外指南推荐意见和最新循证医学证据,形成可供医疗机构临床医师、临床药师等专业人员参考的17条专家共识意见。鉴于感染性疾病的特殊性、复杂性及患者的个体差异性,为使患者获益,本专家共识形成的意见需实施个体化的抗感染策略。

In recent years,the emergence of newly detected pathogens and the increase of drug resistant bacterial bring serious challenges for the diagnosis and treatment of infectious diseases.Tetracycline drugs are widely used in clinical practice,and the varieties of these drugs are constantly being updated.However,there is still a lack of guidance documents for the rational clinical application of tetracycline drugs in China.Meanwhile,some healthcare workers have doubts about their pharmaceutical characteristics,timing and methods of clinical application.In order to further standardize the clinical application of tetracycline drugs and provide professional evidence‑based medicine suggestions for medical personnel in medical institutions,under the leadership of Hospital Infection Control Branch of Chinese Preventive Medicine Association and Clinical Pharmacology Branch of Chinese Pharmacological Society,experts from areas of infection,respiratory medicine,critical care medicine,emergency,infection control,pharmacy and other disciplines organized a consensus meeting and formulated multidisciplinary expert consensus on the rational use of tetracyclines commonly used in clinical practice.This expert consensus is based on the pharmaceutical characteristics of tetracyclines commonly used in China,the mechanism of action and drug resistance status of tetracyclines,combined with the infection site,pathogen characteristics and bacterial drug resistance.This expert consensus also pays attention to special populations and off‑label drug use,and integrates domestic and foreign recommendations and the latest evidence‑based medicine evidence,and 17 expert consensus opinions for clinical physicians,pharmacists,and other professionals in medical institutions to refer to were formed.In view of the particularity and complexity of infectious diseases and the individual differences of patients,in order to benefit patients,individualized anti‑infection strategies should be implemented.