In critically ill patients with sepsis and septic shock, the need for prompt and adequate antibiotic therapy is balanced by the risk of excessive antibiotic exposure that leads to emergence of multidrug-resistant pathogens. As such, antibiotic stewardship programs propose a set of operating rules from antibiotic treatment initiation to de-escalation and finally cessation. In this review, we will describe the rationale for early antibiotic treatment in septic patients, how to optimize initial antibiotic treatment, rules for early treatment discontinuation in pathogen-negative sepsis, and optimal duration of antimicrobial therapy.

中文翻译：

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如何在感染性休克患者中安全实施抗生素管理？

在患有脓毒症和脓毒性休克的重症患者中，需要及时和充分的抗生素治疗与过度抗生素暴露的风险相平衡，这会导致多重耐药病原体的出现。因此，抗生素管理计划提出了一套从抗生素治疗开始到降级和最终停止的操作规则。在这篇综述中，我们将描述脓毒症患者早期抗生素治疗的基本原理、如何优化初始抗生素治疗、病原体阴性脓毒症早期停止治疗的规则以及抗生素治疗的最佳持续时间。