患者 病原和药物选择:社区与院内获得性肺炎的个体化治疗

Pathogens and drug selection in individual treatment in community and hospital acquired pneumonia

指南描述的是群体,倡导的是原则;临床医生面对的是患者个体,提出的是具体治疗方案。在指南的原则下形成的个体差异化治疗体现了疾病治疗的科学与艺术。在社区与院内获得性肺炎的治疗中,必须分析患者本人的基本情况和病情(who)、患病场所可能产生的影响(where),从而选择最合理的抗感染药物(what)。具体应注意经验性治疗与靶向治疗的结合、抗感染药物的基本药理学知识与患者自身状况相结合、指南与本地区耐药情况相结合等问题。

In guidelines,groups are mainly deseribed and the principles advocated. However, clinicians face individual patients in practice and thus should propose detailed treatment plans. The individual differential treatment based on the principles in the guidelines reflects the science and art of disease treatment. In treatment of community and hospital acquired pneumonia, the basic situation and disease conditions （who） , the possible impact of prevalence sites （where） of a patient should be analyzed for the most reasonable selection of anti-infective drugs （what）. Particular attention should be paid to combination of empirical therapy and targeted therapy, combination of basic pharmacological knowledge of anti-infective drugs and the patient＇s own situation and combination between guidelines and the situation of drug resistance in this area et al.