重症感染:准确诊断是规范抗生素治疗的前提

Severe sepsis: appropriate antibiotic therapy depends upon correct diagnosis

重症感染是危重病患者死亡的主要原因。正确的经验性抗生素治疗能够改善重症感染患者的临床预后。非感染性炎症反应与感染的准确鉴别需要综合考虑临床表现、实验室检查、微生物学结果以及生物学标志物。应当根据感染的特点包括感染部位选择经验性抗生素,而不应盲目依赖广谱抗生素。临床医生应当重视感染灶的控制。

Severe sepsis is the major cause of death in critically ill patients, while appropriate empirical antibiotic therapy might improve clinical outcome in patients with severe sepsis. Differential diagnosis of non-infectious inflammation and sepsis requires integration of clinical manifestation, laboratory investigation including microbiologic results, and biomarkers. Choice of empirical antibiotics should be based on characteristics of infection, including focus of infection. Source control is also crucial in the treatment of severe sepsis.