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指南描述的是群体,倡导的是原则;临床医生面对的是患者个体,提出的是具体治疗方案。在指南的原则下形成的个体差异化治疗体现了疾病治疗的科学与艺术。在社区与院内获得性肺炎的治疗中,必须分析患者本人的基本情况和病情(who)、患病场所可能产生的影响(where),从而选择最合理的抗感染药物(what)。具体应注意经验性治疗与靶向治疗的结合、抗感染药物的基本药理学知识与患者自身状况相结合、指南与本地区耐药情况相结合等问题。
The guidelines describe groups and advocate principles; clinicians face individuals and present specific treatment options. The individualized treatment formed under the guideline principle embodies the science and art of disease treatment. In the treatment of community-acquired nosocomial pneumonia, one must analyze the patient’s own condition and condition (who) and the likely location of the affected area to choose the most appropriate anti-infective (what). Specific attention should be paid to the combination of empirical treatment and targeted therapy, the basic pharmacological knowledge of anti-infectives combined with the patient’s own condition, the combination of guidelines and resistance in the region.