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应该这么说，目前除了我国大陆还没有HAP指南以外，其他语种的HAP指南可谓多如牛毛，眼花缭乱，一方面恨自己英文阅读效率太低，另一方面对其中不一样的建议也有点无所适从。不过有这种苦恼的人不只我一个，看看下文就知道：该文讨论了欧洲现行有效的HAP指南情况（该文就列举了10个，如德国、丹麦、荷兰、法国、比利时、英国、希腊、西班牙、土耳其、瑞士），比较了指南发布的内容，以及制定方法等等，并提出了作者的看法。
Hospital-acquired pneumonia guidelines in Europe: a review of their status and future development-2007
Masterton1*, D. Craven2,3, J. Rello4, M. Struelens5, N. Frimodt-Moller6, J. Chastre7, A. Ortqvist8,
G. Cornaglia9, H. Lode10, H. Giamarellou11, M. J. M. Bonten12, H. Eraksoy13 and P. Davey14
1NHS Ayrshire and Arran, Eglington House, Ailsa Hospital, Dalmellington Road, Ayr KA6 0BA, UK; 2Lahey
Clinic Medical Center, Burlington, MA, USA; 3Tufts University School of Medicine, Boston, MA, USA; 4Joan
XXIII University Hospital, University Rovira and Virgili, CIBERes 06-06-0036, Tarragona, Spain; 5Ho坧ital
Erasme, Belgium; 6National Centre for Antimicrobial Infection Control, Copenhagen, Denmark; 7GH Pitie?
Salpe坱rie`re, AP-HP, Paris, France; 8Karolinska Institutet Stockholm, Stockholm, Sweden; 9University of Verona,
Verona, Italy; 10City Hospital, Berlin, Germany; 11Attikon University Hospital, Athens, Greece;
12University Medical Center, Utrecht, The Netherlands; 13Istanbul University, Istanbul, Turkey;
14University of Dundee, Dundee, Scotland, UK
Hospital-acquired pneumonia (HAP) is the most common healthcare-acquired infection contributing to death. Effective management requires accurate diagnosis, administration of a suitable antibiotic regimen early in infection and implementation of prevention strategies. In recent years, there has been a rapid increase in the number of country-specific HAP guidelines in Europe, which vary in their formulation,coverage of different disease aspects and overall recommendations. Development of comprehensive pan-European HAP guidelines would rationalize the conflicting proposals, provide a useful resource and limit guideline proliferation. However, careful consideration needs to be given to the principles of guideline development to ensure that the output is rigorous, broadly applicable and facilitates update as new data becomes available. The use of an evidence-based approach to HAP guideline development is optimal, but is compromised by limitations in the supporting data. The implementation of a formalized evidence grading system is key to introducing consistency into the guideline development process. Pan-European guidelines should provide recommendations on core aspects of HAP common to all treatment settings and locations, and reflect the differing perspectives of the countries involved. Given the different antibiotic susceptibility profiles across Europe, such guidelines should provide general treatment recommendations suitable for local adaptation. The development of such guidelines represents an ideal time to identify priorities for European research, by addressing controversies and identifying previously unconsidered aspects of HAP. Establishing a pan-European consensus on core processes of care should be viewed as an impetus for change to improve clinical practices and should include a suitable implementation strategy.
Keywords: European consensus, guideline development, implementation
Europe(HAP) 2007.pdf
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发表于 2011-12-22 23:47
发表于 2011-12-24 00:32
