1、2023-1-612023-1-622023-1-632023-1-642023-1-652023-1-662023-1-672023-1-682023-1-692023-1-61046%10%头孢哌酮头孢哌酮/舒巴坦舒巴坦哌拉西林哌拉西林/三唑巴坦三唑巴坦亚胺培南亚胺培南25%46%46%43%45%头孢他啶头孢他啶头孢吡肟头孢吡肟阿米卡星阿米卡星头孢噻肟头孢噻肟头孢曲松头孢曲松48%1994199420012001年中国重症监护病房非发酵糖细菌的耐药变迁年中国重症监护病房非发酵糖细菌的耐药变迁中华医学杂志中华医学杂志,2003,83(5):385-390,2003,83(5):385-39
2、047%2023-1-6112023-1-6120%5%10%15%20%25%30%1990-199319941995199619971998Years%ResistanceMDRMDR的危险因素的危险因素-Quinolone-Quinolone应用应用 AmikacinCiprofloxacinImipenemPiperacillinPiperacillin/tazobactamCeftazidimeNeuhauser MM et al.JAMA 2003;289:885-888*Itokazu GS et al.Clin Infect Dis 1996;23:779-784*Pseudo
3、monas aeruginosa的耐药率的耐药率2023-1-6132023-1-6142023-1-6152023-1-616l 3th cephalosporin select:-VRE、ESBLs、Acinetobacter Baumanii,Fungus l Meropenem select:-Meropenem-resi MDR P.aeruginosa l Fluoroquinolone select-MRSA 、Quino-resi-G-、Carbapenem-resi-P.aeruginosa2023-1-6172023-1-6182023-1-6192023-1-620202
4、3-1-621窄谱窄谱抗生素治疗抗生素治疗2023-1-6222023-1-623*抗菌活性范围、抗生素的有效剂量、药动学特性、各种抗菌药物的抗菌活性范围、抗生素的有效剂量、药动学特性、各种抗菌药物的 不良反应和单不良反应和单药治疗的作用都经过委员会的仔细审核药治疗的作用都经过委员会的仔细审核2023-1-6242023-1-625l3th cephalosporin select:-VRE ESBLs Acinetobacter Baumanii,Fungus lMeropenem select:-Meropenem-resi MDR P aeruginosa lFluoroquinolone select-MRSA Quino-resi-G-Carbapenem-resi-P aeruginosa2023-1-6262023-1-6272023-1-6282023-1-6292023-1-630CCM 2003,31(7):1908-142023-1-6312023-1-6322023-1-6332023-1-634