抗生素的降阶梯治疗（de-escalation therapy）是近年来提出的用于治疗重症肺部感染的一个策略，在临床研究和实践中能够有效地提高重症感染治疗的成功率，降低病死率，同时降低住院时间和费用，是感染治疗策略的一大进展。本文就这一策略的概念演变和应用时机作一介绍
Citation：
YIN Jie,SHI Yi. De-escalation therapy in severe pulmonary infectious diseases. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(1): 9-12. doi:
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Munday CJ，Whitehead GM，Todd NJ，et al.Predominance and genetic diversity of community- and hospital-acquired CTX-M extended-spectrum beta-lactamases in York，UK.J Antimicrob Chemother，2004，54：628-633.
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Woodford N，Ward ME，Kaufmann ME，et al.Community and hospital spread of Escherichia coli producing CTX-M extended-spectrum beta-lactamases in the UK.J Antimicrob Chemother，2004，54：735-743.
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Valverde A，Coque TM，Sánchez-Moreno MP，et al.Dramatic increase in prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae during nonoutbreak situations in Spain.J Clin Microbiol，2004，42：4769-4775.
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Livermore DM.The need for new antibiotics.Clin Microbiol Infect，2004，10（Suppl 4）：1-9.
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Paterson DL."Collateral damage" from cephalosporin or quinolone antibiotic therapy.Clin Infect Dis， 2004，38（Suppl 4）：S341-S345.
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- 1. Kollef MH，Sherman G，Ward S，et al.Inadequate antimicrobial treatment of infections：a risk factor for hospital mortality among critically ill patients.Chest，1999，115：462-474.
- 2. 中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南.中华结核和呼吸杂志，2006，29：651-655.
- 3. Ben-David D，Rubinstein E.Appropriate use of antibiotics for respiratory infections：review of recent statements and position papers.Curr Opin Infect Dis，2002，15：151-156.
- 4. Colodner R，Rock W，Chazan B，et al.Risk factors for the development of extended-spectrum beta-lactamase-producing bacteria in nonhospitalized patients.Eur J Clin Microbiol Infect Dis，2004，23：163-167.
- 5. Paramythiotou E，Lucet JC，Timsit JF，et al.Acquisition of multidrug-resistant Pseudomonas aeruginosa in patients in intensive care units：role of antibiotics with antipseudomonal activity.Clin Infect Dis，2004，38：670-677.
- 6. Munday CJ，Whitehead GM，Todd NJ，et al.Predominance and genetic diversity of community- and hospital-acquired CTX-M extended-spectrum beta-lactamases in York，UK.J Antimicrob Chemother，2004，54：628-633.
- 7. Woodford N，Ward ME，Kaufmann ME，et al.Community and hospital spread of Escherichia coli producing CTX-M extended-spectrum beta-lactamases in the UK.J Antimicrob Chemother，2004，54：735-743.
- 8. Valverde A，Coque TM，Sánchez-Moreno MP，et al.Dramatic increase in prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae during nonoutbreak situations in Spain.J Clin Microbiol，2004，42：4769-4775.
- 9. Livermore DM.The need for new antibiotics.Clin Microbiol Infect，2004，10（Suppl 4）：1-9.
- 10. Paterson DL."Collateral damage" from cephalosporin or quinolone antibiotic therapy.Clin Infect Dis， 2004，38（Suppl 4）：S341-S345.
