CAJ | 학술논문

目的：评估自实施临床路径和抗菌素分级管理制度以来初始经验性抗菌治疗在社区获得性肺炎（CAP）治疗中的作用及痰培养结果分析。方法对符合临床路径的160例社区获得性肺炎患者按经验性首选抗菌素进行分组，分别对疾病分布、使用对象、例数、疗效、药物分布情况及痰培养结果进行统计。结果初始经验性抗菌治疗首选最多的抗菌素是含酶抑制剂的青霉素类，二代头孢菌素和呼吸喹诺酮，与《社区获得性肺炎诊断和治疗指南》（以下简称指南）初始经验性抗感染治疗的建议基本吻合，也间接说明 CAP 患者病原体与指南所列相一致。结论CAP 患者的治疗仍以初始经验性抗菌治疗为主，以相关指南为依据的正确的经验性抗菌治疗可以治愈绝大多数 CAP，痰的病原学检查对 CAP 治疗的指导作用有限。
목적：평고자실시림상로경화항균소분급관리제도이래초시경험성항균치료재사구획득성폐염（CAP）치료중적작용급담배양결과분석。방법대부합림상로경적160례사구획득성폐염환자안경험성수선항균소진행분조，분별대질병분포、사용대상、례수、료효、약물분포정황급담배양결과진행통계。결과초시경험성항균치료수선최다적항균소시함매억제제적청매소류，이대두포균소화호흡규낙동，여《사구획득성폐염진단화치료지남》（이하간칭지남）초시경험성항감염치료적건의기본문합，야간접설명 CAP 환자병원체여지남소렬상일치。결론CAP 환자적치료잉이초시경험성항균치료위주，이상관지남위의거적정학적경험성항균치료가이치유절대다수 CAP，담적병원학검사대 CAP 치료적지도작용유한。
Objective To evaluate the effect of initial empirical antibiotherapy in CAP since the practice of the clinical path -way and the classification management of antibiotic and the analysis of sputum culture .Methods One hundred and sixty patients with CAP consistent with the clinical pathway were divided according to the preferred choice of empiric antibiotherapy , the results of disea-ses distribution, objective, number, therapeutic effect, drug distribution and sputum culture were listed .Results The most preferred antibiotic of initial empiric antibiotherapy were penicillins with a β-lactamase inhibitor, bibasic cephalosporin and respiratory fluoro -quinolone, it was identical with the recommendation of guideline and indirectly demonstrated that the pathogen of CAP was identical with the guideline.Conclusions The initial therapy of CAP is still depended on empirical antibiotherapy , the most CAP are cured by correct empirical antibiotharepy according to the guideline , the instruction effect of the pathogen detection of sputum to the therapy of CAP is limited.