[基础医学]周发春---生物标记物对于抗生素合理用药的指导价值.pdfVIP

生物标记物对于抗生素 合理用药的指导价值 周发春 重庆医科大学附属第一医院重症医学科 INTRODUCTION Surveys reveal that 25–33% of hospitalized patients receive antibiotics and that 22–65% of antibiotic use in hospitalized patients is inappropriate Fraser GL. Arch Intern Med. 1997,157:1689–94 Antibiotic Overuse:  Drug-related adverse events nausea, diarrhea, rash …  Economic burden  Antibiotic resistance Reduction in length of antibiotic courses was the antibiotic use strategy most likely to be effective in reducing antibiotic resistance Louis Rice. Modalities to reduce antimicrobial resistance 45th Annual Meeting of the IDSA 抗生素运用的黄金分割点? Better biomarkers for diagnosing infection would improve the appropriateness of antibiotic use Early and Reliable diagnosis of infection still poses difficulties in this setting but also represents a crucial step toward appropriate antimicrobial therapy Pagani, L. et al. Crit Care, 2011,15(6): 238 提纲 1、 有哪些生物标记物？ 2 、各种生物标记物的优势？ 3、何种生物标记物最为常用？ 4 、生物标记物运用的现状及意义？ 5、光环背后的思考 指导抗生素运用的 生物标记物 Time Course of Various Parameters of the Systemic inflammatory Response Meisner M. J Lab Med 1999,23:263-72 ROC of PCT vs. Other Markers Better sensitivity and specificity Muller et al. Critical Care Med 2000,28:977-83 Sample Convenience PCT s-TREM-1 Blood Bronchoalveolar fluid Non-Steroid Impact Intensive Care Med. 2008.34(3): 518–22