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< レクチャーメモ Suppressive ... | メイン | メモ：リファンピシン投与時のステロイド増... >
Chest. 2006;129:1210-1218: The concept of deescalation therapy is emerging as an effective strategy for the management of "Ventilator-Associated Pneumonia" and other serious infections（Chest 2002;122,2183-2196）.
"Therapy escalation" was defined as the switch to or addition of a drug class or classes with a broader spectrum or additional coverage. Deescalation was defined as a switch to or discontinuation of a drug class resulting in a less broad spectrum of coverage(=This concept entails the early implementation of broad-spectrum empiric coverage followed by a regimen tailored according to susceptibility findings).
免疫抑制療法中の肺炎であれば、緑膿菌はカバーするか？誤嚥の要素を考慮するか？MRSAに対するバンコマイシンを含めるか？
吸痰の培養結果がでれば抗菌薬を絞る。
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