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药物与治疗

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急性细菌性鼻窦炎(ABS)
原作者: ennifer Guyther,李辉译, 发布日期:2015-03-02

Title: Acute Bacterial Sinusitis (ABS)
题目:急性细菌性鼻窦炎(ABS)
Author 作者: Jennifer Guyther
翻译:李辉 校对:肖锋

6-7% of kids presenting with upper respiratory symptoms will meet the definition for ABS.
百分之六至七有上呼吸道症状儿童会符合急性细菌性鼻窦炎(ABS)的诊断。
The American Academy of Pediatrics (AAP) reviewed the literature and developed clinical practice guideline regarding the diagnosis and management of ABS in children and adolescents.
美国儿科学会回顾了文献并建立了关于儿童及青少年ABS诊断及治疗的临床实践指南。
The AAP defines ABS as: persistent nasal discharge or daytime cough > 10 days OR a worsening course after initial improvement OR severe symptom onset with fever > 39C and purulent nasal discharge for 3 consecutive days.
美国儿科学会将ABS定义为:持续的流涕或日间咳嗽超过10天;或早期改善之后再恶化;发病时症状严重并伴发烧超过39度;和流脓性鼻涕连续3天。
No imaging is necessary with a normal neurological exam.
如神经检查正常,无需影像学检查。
Treatment includes amoxicillin with or without clavulanic acid (based on local resistance patterns) or observation for 3 days.
Optimal duration of antibiotics has not been well studied in children but durations of 10-28 days have been reported.
治疗包括阿莫西林含或不含克拉维酸(依据当地的耐药谱),或观察3天。抗生素在儿童中的持续使用时间目前仍未有深入的研究,但是已有使用10-28天的报道。
If symptoms are worsening or there is no improvement, change the antibiotic.
如果症状加重或没有改善,更换抗生素。
There is not enough evidence to make a recommendation on decongestants, antihistamines or nasal irrigation.
目前没有足够的证据推荐使用鼻黏膜收缩剂,抗组胺药物及鼻腔冲洗。

References 参考文献:
Wald et al. Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years. Pediatrics. Volume 132, Number 1, July 2013.