2007年粒细胞减少患者抗感染指南（中英对照版）.ppt

肿瘤合并粒细胞减少病人抗生素使用临床实践指南 2007 UPDATE进行中 Alison Freifeld, MD IDSA 粒减伴发热治疗专家组主席 一、此处添加标题 CLINICAL PRACTICE GUIDELINE FOR THE USE OF ANTIMICROBIAL AGENTS IN NEUTROPENIC PATIENTS WITH CANCER: 2007 UPDATE In Progress Alison Freifeld, MD Chair, IDSA Expert Panel on Management of Fever and Neutropenia Disclosures Research support: Enzon, Astellas, Vical Consuling: Schering-Plough Scientific Advisory Board: Enzon Speaker’s bureaus: none currently (9/06-9/07) Panel Members Alison Freifeld, MD, Chair Michael Boeckh, MD Eric J. Bow, MD, MSc James I. Ito, MD Craig Mullen, MD, PhD Issam I. Raad, MD Kenneth V.Rolston, MD Kent A. Sepkowitz, MD Jo-Anne van Burik, MD John R. Wingard, MD Stuart Cohen, MD, SPGC Liaison 专家组成员 Alison Freifeld, MD, Chair Michael Boeckh, MD Eric J.Bow, MD, MSc James I,Ito, MD Craig Mullen, MD,PHD Issam I.Raad, MD Kenneth V.Rolston, MD Kent A.Sepkowitz, MD Jo-Anne van Burik, MD John R.Wingard, MD Stuart Cohen, MD, SPGC Liaison Guideline Comparison 2002 Guidelines ???? Clinical features of the neutropenic patient ???? Evaluation of the patient ???? Initial antibiotic therapy 2007 Update ???? Clinical features ???? Risk assessment: definitions of high and low risk ???? Evaluation of the patient ???? Initial antibiotic therapy ???? High risk ???? Low risk 指南对比 2002 指南 粒减病人 的临床特征 病人的评估 初始抗生素治疗 2007 更新 临床特征 风险评估；高危和低危的定义 病人的评估 初始抗生素治疗 高危 低危 Guideline Comparison cont. (2) 2002 Guidelines ???? Management during the first week ???? Afebrile day 3-5 ???? Persistent fever day 3-5 ???? Duration of antibiotics ???? Afebrile by day 3 ???? Persistent fever on day 3 2007 Update ???? Management during the first week ???? Documented infections ???? Fever of unknown etiology ???? Duration of antibiotics ???? Documented infections ???? Fever of unknown etiology: high risk or low risk patients 指南对比（2） 2002 指南 第一周的治疗 无发热天数 3－5 持续发热天数3－5 抗生素持续时间 无发热天数3 持续发热天数3 2007 更新 第一周的治疗 证实的感染 不明病因的发热 抗生素持续时间 证实的感染 不明病因的发热：