严重脓毒症抗生素应用策略PPT.pptVIP

20090422 CJ 1 CJ 32 CARES 2006-2007：284株大肠杆菌 CJ 33 SICU:大肠埃希氏菌 陈娟，等，中华外科杂志，2006，44（17）：1189-1192 CJ 34 中国10家教学医院铜绿假单胞菌的耐药性 （CMSS,2006年) S% CJ 35 CARES 2006-2007：148株铜绿假单胞 CJ 36 SICU:铜绿假单胞菌 陈娟，等，中华外科杂志，2006，44（17）：1189-1192 CJ 37 % S 中国10家教学医院克雷伯菌的耐药性（CMSS,2006年) CJ 38 CARES 2006-2007：149株肺克 CJ 39 SICU:肺炎克雷伯菌 陈娟，等，中华外科杂志，2006，44（17）：1189-1192 CJ 40 Recommendations (with ratings) for management of antimicrobial agent resistance High levelb of carbapenem-resistant P. eruginosa Reducec fluoroquinolone and ? or carbapenem use BIII 2. High level of fluoroquinolone resistant P.eruginosa Reduce fluoroquinolone use and change primary drug to ciprofloxacin AI 3. High level of carbapenem-resistant A. baumannii Reduce carbapenem use and assess for clonal problem AII L. R. Peterson, Clin Microbiol Infect 2005; 11 (Suppl. 5): 4–16 CJ 41 Recommendations (with ratings) for management of antimicrobial agent resistance 4. High level of b-lactam resistance in P. aeruginosa Reduce extended-spectrum cephalosporin use and replace with piperacillin–tazobactam BIII 5. High level of ESBL-producing Enterobacteriaceae Reduce extended-spectrum cephalosporin use and replace with piperacillin–tazobactam or imipenem–cilastatin or ampicillin–sulbactam AI 6. High level of gentamicin–tobramycin resistance in Enterobacteriaceae Replace with amikacin AI L. R. Peterson, Clin Microbiol Infect 2005; 11 (Suppl. 5): 4–16 CJ 42 Recommendations (with ratings) for management of antimicrobial agent resistance 7. Concern over presence of VRE Reduce cephalosporin and fluoroquinolone use and replace with piperacillin–tazobactam AI 8. Concern over presence of MRSA Reduce cephalosporin and fluoroquinolone use, and replace with a b-lactamase inhibitor drug