成人社区获得性肺炎抗感染治疗标准方案的中美诊疗指南对比及解析

Comparison and Analysis of Chinese and American Guidelines for Standard Regimens of Anti-infectious Therapy of Adults'Community Acquired Pneumonia

社区获得性肺炎(CAP)是临床多发的感染性疾病之一。近年来,广谱抗菌药物大量使用,CAP病原耐药谱趋于复杂,使CAP的诊疗日益困难。2016年中华医学会呼吸学分会感染学组发布《中国成人社区获得性肺炎诊断和治疗指南》(简称中国指南),2019年美国胸科学会(ATS)与美国感染病学会(IDSA)发布《2019 ATS&IDSA临床实践指南:成人社区获得性肺炎的诊断和治疗》(简称ATS&IDSA指南)用于规范临床诊疗。笔者综合中国指南和ATS&IDSA指南,重点探讨CAP抗感染治疗方案,将两者的差别和一致强调的内容进行比较,为临床诊疗提供参考。

Community-acquired pneumonia(CAP)is a common clinical infectious disease with high mortality.In recent years,the abuse of anti-infective drugs,the changing drug-resistance spectrum of CAP pathogens,and the emergence of drug-resistant and multidrug-resistant pathogens have greatly increased the difficulty of CAP diagnosis and treatment.To standardize clinical diagnosis and treatment,the American Thoracic Society(ATS)and the Infectious Diseases Society of America(IDSA)released the"2016 Chinese Guidelines"in 2016 and the 2019 ATS&IDSA Clinical Practice Guidelines:Diagnosis and Treatment of Adult Community-Acquired Pneumonia(hereinafter referred to as the 2019 ATS&IDSA Guidelines).Each of these publications was produced by the Infectious Group of the Respiratory Branch of the Chinese Medical Association.The 2019 ATS&IDSA guidelines issued an expert consensus on the above-mentioned issues,and put forward suggestions on diagnosis,evaluation,and treatment plans in the form of questions and answers.At the same time,the author also concentrates on the anti-infective treatment strategy in conjunction with the Chinese standards.