Community-acquired pneumonia guidelines: much guidance, but not much evidence
Community-acquired pneumonia guidelines: much guidance, but not much evidence
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社区获得性肺炎指南：指导较多，但证据不多
DOI：
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发表时间：
2002
影响因子：
24.3
通讯作者：
M. Woodhead
中科院分区：
文献类型：
--
作者：
M. Woodhead
社区获得性肺炎（CAP）正在发生变化。常见致病菌中抗生素耐药性的出现和传播、新的微生物诊断技术的发展、严重性评估领域的新认识以及新抗生素的开发只是其中的一些问题。指导方针的编写方法也在不断发展1。证据的分类和建议的强度可能是对这种方法的最重要的补充。因此，较旧的联合呼吁程序管理准则的某些方面可能已经过时35。
英国胸科学会（BTS）6和美国胸科学会（ATS）于2001年发布了CAP 7管理指南，加拿大于2000年发布了CAP 8，9和北美传染病学会（IDSA）指南10，这是最受欢迎的。他们都更新或修订了以前的出版物（分别间隔8年、8年、7年和2年），并试图考虑到上述问题。每份文件的范围相似，包括临床表现和诊断、微生物和非微生物研究以及一般和抗生素管理等问题。疾病控制和预防中心提出了一个单独的出版物，仅限于抗生素的建议11。本文件的目的不是逐项比较这些文件，而是一般性地评估它们的潜在价值和局限性，以及如何和在何处可以或不可以使用它们。
指导方针是，我们是否...
Community-acquired pneumonia (CAP) is changing. The emergence and spread of antibiotic resistance in common causative bacteria, the development of new microbiological diagnostic techniques, new understandings in the area of severity assessment and the development of new antibiotics are just some of the issues. Methods of guideline writing have also evolved 1. The categorisation of evidence and the strength attributed to recommendations are perhaps the most important additions to this methodology 2. Some aspects of the older guidelines for CAP management may therefore be out of date 35.
The publication of the British Thoracic Society (BTS) 6 and American Thoracic Society (ATS) Guidelines for the management of CAP 7 in 2001 and the Canadian 8, 9 and The Infectious Disease Society of North America (IDSA) Guidelines 10 in 2000 were most welcome. They all updated or revised earlier publications (after intervals of 8, 8, 7 and 2 yrs, respectively) and attempted to take account of the issues mentioned above. The scope of each document is similar and they include issues such as clinical presentation and diagnosis, microbial and nonmicrobial investigation and general and antibiotic management. A separate publication confined to antibiotic recommendations was presented by the Centers for Disease Control and Prevention 11. It is not the purpose of this paper to compare these documents item by item, but more to assess in general terms, their potential value and limitations and how and where they may or may not be used.
Guidelines are, whether we …