【正文】
還需要調(diào)查! ? 降階式療法在重癥病患, 可以立即改善病情 ,從 ICU 轉(zhuǎn)入普通病房,因而減少其醫(yī)療費(fèi)用! ? 較快的治癒感染,可以減少住院期間! ? 學(xué)會(huì) 『 降階 』 , 也可以壓低醫(yī)療費(fèi)用的增加! ? 臺(tái)灣 260個(gè) 一般感染病例 中至少有 32例 (% ),因選藥錯(cuò)誤,拖延治癒期間 (至少 57天 ); ICU病患會(huì)拖延更久 ,而浪費(fèi)更多的費(fèi)用! 感染癥的處理 『 不確定性 』 最顯著 ? 感染癥專科醫(yī)師要 盡量依據(jù)已有的文獻(xiàn)資料 給病患最安全的治療, 因此他的意見 應(yīng)該是最可靠的 。113:412420. Luna CM et al. Chest 1997。118L146155. Kollef MH et al. Chest 1999。115:462474. Mortality Associated With Initial Inadequate Therapy In Critically Ill Patients With Serious Infections in the ICU 0% 20% 40% 60% 80% 100 % Luna, 1997 Ibrahim, 2021 Kollef, 1998 Kollef, 1999 Rello, 1997 AlvarezLerma,1996 Initial appropriate therapy Initial inadequate therapy *Mortality refers to crude or infectionrelated mortality AlvarezLerma F et al. Intensive Care Med 1996。118:146155. Iregui M et al. Chest 2021。 Gert Hoeffken, Universitat Dresden, Dresden, Germany Gee Karam, Louisiana State University Medical School, New Orleans, LA Marin Kollef, Washington University School of Medicine, St. Louis, MO Carlos Luna, University of Buenos Aires, Argentina Michael Niederman, Winthrop University Hospital, Mineola, NY David Paterson, University of Pittsburgh Medical School, PA Jordi Rello, University Hospital Joan XXIII, Tarragona, Spain JeanLouis Trouillet, Groupe Hospitalier PITIE SALPETRIERE, Paris, France Getting It Right From Start To Finish: The Role of DEESCALATION THERAPY? ? Consensus II Initial “Inadequate Therapy” In Critically Ill Patients with Serious Infections Myth ? There