Treatment of Complicated Skin and Soft Tissue Infections
Treatment of Complicated Skin and Soft Tissue Infections
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DOI：
10.1089/sur.2009.012
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发表时间：
2009-10-01
影响因子：
2
通讯作者：
Eachempati, Soumitra R.
中科院分区：
文献类型：
--
作者：
May, Addison K.;Stafford, Renae E.;Eachempati, Soumitra R.
背景：皮肤和软组织感染（SSTIs）可产生很高的发病率和死亡率，特别是那些被归类为复杂或坏死性的感染。目的：采用推荐、评估、发展和评价分级（GRADE）方法衡量建议的强度，为ssti的诊断和管理提供循证建议。数据来源：已发表研究的计算机识别和相关文章的综述。研究选择：所有已发表的关于复杂和坏死性ssit治疗的报告均由外科感染学会的专家小组根据已出版的循证医学指南进行评估。证据的质量由GRADE方法和标准来判断。实践调查、药代动力学研究和提出已考虑的原始数据的评论或重复出版物被排除在分析之外。数据提取：提取人口统计学信息、研究日期、微生物学发现、抗生素类型、手术干预、感染相关结果和研究的方法学质量。在形成最终共识文件之前，结果提交给外科感染学会治疗剂委员会进行审查。数据综合：目前复杂ssti的手术和抗生素管理是基于少数研究，这些研究往往没有足够的力量得出有充分支持的结论，但非坏死性软组织感染的抗菌治疗除外，这方面的数据充足。
Background: Skin and soft tissue infections (SSTIs) may produce substantial morbidity and mortality rates, particularly those classified as complicated or necrotizing.Objective: To weigh the strength of recommendations using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methodology and to provide evidence-based recommendations for diagnosis and management for SSTIs.Data Sources: Computerized identification of published research and review of relevant articles.Study Selection: All published reports on the management of complicated and necrotizing SSITs were evaluated by an expert panel of members of the Surgical Infection Society according to published guidelines for evidence-based medicine. The quality of the evidence was judged by the GRADE methodology and criteria. Practice surveys, pharmacokinetic studies, and reviews or duplicative publications presenting primary data already considered were excluded from analysis.Data Extraction: Information on demographics, study dates, microbiology findings, antibiotic type, surgical interventions, infection-related outcomes, and the methodologic quality of the studies was extracted. Results were submitted to the Therapeutic Agents Committee of the Surgical Infection Society for review prior to creation of the final consensus document.Data Synthesis: Current surgical and antibiotic management of complicated SSTIs is based on a small number of studies that often have insufficient power to draw well-supported conclusions, with the exception of antimicrobial therapy for non-necrotizing soft tissue infections, for which ample data are available.