脓毒症抗生素治疗策略

Treatment strategy with antimicrobial agents for pediatric sepsis

合理选择使用抗生素仍是降低脓毒症病死率的关键措施。根据流行病学、患儿年龄、感染部位、感染地点等判断可能的病原,进行初始经验治疗,并根据病原培养结果进行针对性治疗是脓毒症治疗的基础。治疗中还要根据药代动力学/药效动力学优化抗生素使用效率,并注意药物不良反应,同时注意其他综合性治疗措施,抗微生物治疗疗效不佳时要注意重新评估诊断是否正确。

Severe sepsis remains a major cause of death in children. Timely and appropriate use of antimicrobial agents is associated with lower mortality and continues to he a cornerstone of therapy for patients with sepsis. Initial empirical therapy is mainly relying on epidemiology, age, site of infection, and the place of infection. Once the pathogen is clear, we should treat the patient accordingly. In addition, we should consider the PK/PD and side effects of the agents, pay attention to other therapeutic measures, such as increasing immunity of host and eradication of infection focus. The diagnosis should be reassessed if the patient is not improved.