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常见侵入性诊疗操作预防性使用抗菌药物专家共识
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| 篇名： | 常见侵入性诊疗操作预防性使用抗菌药物专家共识 |
| TITLE： | Expert consensus on prophylactic use of antimicrobial agents in common invasive diagnostic and therapeutic procedures |
| 摘要： | 目的 为临床提供围操作期预防性使用抗菌药物的指导性建议，以提升抗菌药物使用的科学性与合理性。方法基于《手术操作分类代码国家临床版3.0》体系，筛选出符合本共识研究范围的诊断性操作、治疗性操作和介入治疗3类侵入性诊疗操作，按照关键操作技术、入路、推荐意见等进行合并；检索中英文数据库，收集近10年国内外指南/共识及系统性评价，为《抗菌药物临床应用指导原则（2015版）》（以下简称《指导原则》）未包含操作的预防性使用抗菌药物问题给出推荐意见或对《指导原则》已有操作的预防性使用抗菌药物问题给出更详细的推荐意见。通过德尔菲法和专家研讨会形成共识推荐意见，以70%的专家同意（专家达成率）为共识达成标准。结果与结论共纳入1164项侵入性诊疗操作条目，经过2轮德尔菲法和3轮专家研讨会最终形成本共识。相较于《指导原则》，本共识明确给出23条建议预防性使用抗菌药物、21条不建议预防性使用抗菌药物和23条不建议常规预防性使用抗菌药物的侵入性诊疗操作推荐意见，并细化了高危因素范围与推荐用药时长。本共识为不同侵入性诊疗操作场景下抗菌药物预防使用提供了明确的指导，有助于提高抗菌药物的使用合理性、减少细菌耐药的发生，同时可能有助于提高侵入性诊疗操作的安全性，改善患者预后。 |
| ABSTRACT： | OBJECTIVE To provide the guiding recommendations for the prophylactic use of antimicrobial agents during the perioperative period in clinical practice， with the aim of enhancing the scientificity and rationality of antimicrobial agents. METHODS Based on National Clinical Classification and Coding System for Surgical Procedures Version 3.0， three categories of invasive diagnostic， therapeutic and interventional procedures that fell within the research scope of this consensus were screened out. These procedures were then consolidated according to key operative techniques， approaches， and recommendations. A search was conducted through Chinese and English databases for domestic and foreign guidelines/consensus documents and systematic reviews published in the past decade. The aim was to provide recommendations of prophylactic use of antimicrobial agents for procedures not covered in the Guiding Principles for Clinical Application of Antimicrobial Agents （2015 edition） （hereinafter referred to as the Guiding Principles） or to offer more detailed recommendations of prophylactic use of antimicrobial agents for procedures already included in the Guiding Principles. Consensus recommendations were ultimately formulated through the Delphi method and expert seminars， with a 70% agreement rate among experts （the consensus achievement rate） serving as the criterion for consensus attainment. RESULTS & CONCLUSIONS A total of 1 164 entries of invasive diagnostic and therapeutic procedures were included. After two rounds of the Delphi method and three rounds of expert seminars， this consensus was ultimately established. Compared to the Guiding Principles， this consensus explicitly proposes 23 recommendations advocating prophylactic use， 21 recommendations against prophylactic use， and 23 recommendations against routine prophylaxis in invasive diagnostic and therapeutic procedures. Additionally， it specifies high-risk factor criteria and optimizes the duration of recommended medication. The consensus offers explicit guidance on the prophylactic use of antimicrobial agents in various scenarios of invasive diagnostic and therapeutic procedures. It is conducive to enhancing the rational use of antimicrobial agents， mitigating the emergence of bacterial resistance. Additionally， it may potentially contribute to improving the safety of invasive procedures and optimizing patient outcomes. |
| 期刊： | 2025年第36卷第10期 |
| 作者： | 江苏省药学会感染药学专业委员会 |
| AUTHORS： | Infectious Diseases Pharmacists Committee of Jiangsu Pharmaceutical Association |
| 关键字： | 侵入性诊疗操作；抗菌药物；预防；围操作期 |
| KEYWORDS： | invasive diagnostic and therapeutic procedures； antimicrobial agents； prophylactic； perioperative period |
| 阅读数： | 6 次 |
| 本月下载数： | 47 次 |
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