抗菌药物临床管理与合理应用__培训课件.pptVIP

* * * * * Fighting Infection In The First hours Rapid tests When available. Gram stain!!! Start adequate antibiotic coverage (within 1 hour?) Tillou A et al. Am Surg 2004;70:841-4 Drain purulent collection Sampling Including invasive procedures when needed (BAL…) 经验性治疗和目标治疗的统一 留取标本进行微生物学检查 开始经验性抗感染治疗 目标治疗 选择哪种抗菌药物(which antibiotic?) 感染部位的常见病原学(possible pathogens on site of infection) 选择能够覆盖病原体的抗感染药物(antibiotics requirement) -抗菌谱/组织穿透性/耐药性/安全性/费用 考虑药代动力学/药效动力学(PK/PD) 考虑病人生理和病理生理状态( physiologic and pathophysiology) 高龄/儿童/孕妇/哺乳(advanced age/children/pregnant women/breast f