抗生物質政策は,耐性バシリ発生を防止するためのものです
P de Man1, B A Verhoeven, H A Verbrugh
1Department of Medical Microbiology and Infection Control, Erasmus University Medical Centre, Rotterdam, The Netherlands. peter_de_man@franciscus.nl
Lancet (London, England)
|April 18, 2000
まとめ
新生児集中治療室 (NICU) の抗生物質戦略の変更は,抗菌剤耐性を減らすことができます. アモキシチリンとセフォタキシムを避けたことにより,新生児の耐性細菌のコロニー化のリスクが著しく低下しました.
科学分野:
- 新生児集中治療室の新生児集中治療室は,新生児集中治療室の新生児集中治療室の新生児集中治療室です.
- 感染症の疫学について
- 抗菌薬の管理について
背景:
- 新生児重症治療室 (NICU) は,感染の恐れのために経験的に幅広いスペクトルの抗生物質を頻繁に使用し,無意識に抗生物質耐性を促進します.
- 抗生物質の代替療法の研究は,耐性菌株を好む選択的圧力を軽減するために極めて重要です.
研究 の 目的:
- NICUにおける抗菌剤耐性の出現に対する異なる経験的抗生物質療法の影響を評価する.
- 抗生物質戦略を改変することで,耐性菌株の発生を阻止できるかどうかを判断する.
主な方法:
- 2つの同一のNICUを対象とした比較研究で,それぞれが新生児のセプシスに対する異なる経験的抗生物質レジメンを割り当てられました.
- レジメンは6ヶ月後にユニット間で切り替えられ,直腸と呼吸器の培養物は毎週収集された.
- 抗生物質療法には,ペニシリンG/トブラミシンまたはフクロキシサシリン/トブラミシン (ユニットA) とアモキシシリン/セフォタキシム (ユニットB) が含まれていた.
主要な成果:
- アモキシチリン-セフォタキシム療法は,ペニシリン-トブラミシン療法の (3人の新生児) に比べて,耐性細菌によるコロニー化率 (41人の新生児) が著しく高かった.
- 耐性菌株によるコロニゼーションの相対的なリスクは,アモキシチリン-セフォタキシム療法で1000患者日あたり18倍でした.
- 特定の細菌パターンが現れ,エンテロバクター・クロアカエはアモキシチリン-セフォタキシムが優勢で,エシェリキア・コライはペニシリン-トブラミシンが優勢であった.
結論:
- 経験的な抗生物質政策は,新生児集中治療室における抗菌剤耐性の制御に重大な影響を及ぼします.
- アモキシチリンとセフォタキシムを避けるレジメンは,抗生物質耐性問題の発生を効果的に制限します.
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