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真菌感染流行病学的变化对治疗时机及药物选择具有重要影响。多项指南已确立早期经验治疗的地位[1-2],同时病原真菌种类变迁,也促使医生选择更广谱的抗真菌药物[3-4]。这些势必增加其耐药性、医疗费用及药物副反应。笔者认为,在决策经验治疗前,临床医生应以可能的感染部位为指导,并结合病人情况制定个体化治疗措施,提高治疗准确性并避免过度治疗。
Epidemiological changes in fungal infections have important implications for the timing and choice of drugs. Several guidelines have established the status of early experience in treatment [1-2], while changes in the species of pathogenic fungi, but also prompted doctors to choose a broader spectrum of antifungal drugs [3-4]. These are bound to increase their resistance, medical costs and drug side effects. The author believes that before the decision-making experience in treatment, clinicians should be possible parts of the infection as a guide, combined with the patient to develop individualized treatment measures to improve the accuracy of treatment and avoid over-treatment.