短期間,高用量のアモキシチリン治療が耐性肺炎球菌の伝播に与える影響:ランダム化試験
S J Schrag1, C Peña, J Fernández
1Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, MS C23, 1600 Clifton Rd, Atlanta, GA 30333, USA. zha6@cdc.gov
JAMA
|July 4, 2001
まとめ
短期間,高用量のアモキシチリン療法により,小児における耐性肺炎球菌の伝播が著しく減少しました. このアプローチは,抗生物質耐性の広がりを制限するのに役立ちます.
科学分野:
- 感染症 感染症は感染症です.
- 薬理学 薬理学とは
- 公衆衛生は公衆衛生である.
背景:
- Streptococcus pneumoniaeの抗生物質耐性は,肺炎球菌感染症の治療に重大な脅威をもたらしています.
- 抗生物質の投与量と投与期間を最適化することは,耐性菌株の拡散を制御するために極めて重要です.
研究 の 目的:
- 短期間,高用量のアモキシシリンの投与が,呼吸器感染症の小児における耐性肺炎球菌伝染のリスクを低下させるかどうかを評価する.
主な方法:
- ドミニカ共和国の無作為化試験では,呼吸器疾患を有する795人の子ども (6~59ヶ月) が参加した.
- 参加者は,高用量 (90 mg/kg/日5日間) または標準用量 (40 mg/kg/日10日間) のアモキシチリンを投与された.
- 鼻のスランプは,ペニシリン不感受性Streptococcus pneumoniaeの輸送を複数の時間点で評価した.
主要な成果:
- 短期間,高用量群は,28日後に耐性肺炎球菌の伝播のリスクが著しく低下した (24%対32%) ことを示した.
- この治療法は,トリメトプリム-スルファメトキサゾール不感受性の低下に向けた傾向を示した.
- 短期間,高用量群ではより高い遵守率 (82%対74%) が観察されました.
結論:
- 短期的な高用量アモキシチリン治療は,抗生物質耐性を減らすための有望な戦略です.
- この治療的アプローチは,抗生物質の使用が薬剤耐性の肺炎球菌の拡散に及ぼす影響を効果的に最小限に抑えることができます.
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