敗血症治療における抗菌薬適正使用プログラム:原則、影響、および将来の方向性
1Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
The Korean journal of internal medicine
|December 22, 2025
まとめ
抗菌薬適正使用プログラム(ASP)は、敗血症ケアにおける薬剤耐性(AMR)と戦う上で極めて重要である。効果的なASPは患者転帰を改善し、医療費を削減するが、投資の増加と一貫した実施が必要である。
科学分野:
- 集中治療医学
- 感染症
- 公衆衛生
背景:
- 敗血症は、薬剤耐性(AMR)の増加による死亡率の上昇を伴う、重大な世界的健康脅威をもたらす。
- 抗菌薬適正使用プログラム(ASP)は、抗生物質の適正使用とAMRの軽減に不可欠である。
- AMRの増大は敗血症治療を複雑にし、現在の治療戦略の再評価を必要とする。
研究 の 目的:
- 敗血症治療におけるASPの適用と影響をレビューすること。
- 患者転帰の改善と多剤耐性菌との戦いにおけるASPの役割を強調すること。
- 敗血症ケアにおけるASP実施の課題と将来の方向性を特定すること。
主な方法:
- 敗血症におけるASPに関する国際的および韓国の研究の文献レビュー。
- AMRの文脈における敗血症管理ガイドラインの評価。
- ASPのコア原則と実施障壁の分析。
主要な成果:
- 効果的なASPは、患者転帰の改善、入院期間の短縮、および医療費の削減に関連している。
- ASPは、抗生物質関連の有害事象の発生率を低下させ、AMRを削減することができる。
- 診断の遅延、人員不足、および一貫性のない実施は、ASPの効果に対する主な障壁である。
結論:
- 敗血症における責任ある抗生物質使用のためには、ASPへの投資と関与の増加が不可欠である。
- 将来の努力は、迅速診断、個別化治療、およびインフォマティクスをASPに統合することに焦点を当てるべきである。
- 多様な敗血症患者集団におけるASPの効果に関する堅牢な証拠を確立するためには、さらなる研究が必要である。
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