儿童社区获得性细菌性肺炎的抗菌药物治疗

Antimicrobial treatment for community-acquired bacterial pneumonia in children

社区获得性肺炎(CAP)是5岁以下儿童发病和死亡的主要原因,细菌是CAP的主要病原之一。由于病原学检查结果难以及时获得,初始抗菌药物治疗多为经验性。应依据患儿年龄、基础疾病、疾病严重度、抗菌药物应用史及其治疗反应等综合判断可能的病原菌及是否存在多重耐药,并结合当地细菌耐药监测数据选择合适的抗菌药物。在获知细菌培养及药敏结果后,结合临床疗效及时调整给药方案,采取目标性治疗。优化抗菌药物治疗方案,可提高CAP治疗成功率,并有助于减少抗菌药物耐药。

Community-acquired pneumonia（CAP） is the leading cause of morbidity and mortality in children under 5 years of age,and bacteria are one of the major causes of CAP.The results of pathogen identification are difficult to obtain in time,so the initial antimicrobial treatment is mostly empirical.The possible pathogens and multi-drug resistance should be judged based on the age,the underlying diseases,the severity of the disease,the history of previous antimicrobial use and the response to the treatment. The antimicrobial drugs can be chosen through combination with the monitoring of local bacteria resistance. After knowing the results of bacterial detection and drug susceptibility,and through combination with the response to the treatment,the regimens should be adjusted timely and the targeted treatment should be adopted. Optimizing antimicrobial regimens may increase the success rate of CAP treatment and help to reduce antimicrobial resistance.