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バクテリア性心臓内膜炎の予防. アメリカ心臓協会の勧告
A S Dajani1, K A Taubert, W Wilson
1American Heart Association, Dallas, Tex 75231, USA.
JAMA
|June 11, 1997
まとめ
バクテリア性心臓内膜炎の予防のための最新のガイドラインは,リスクの階層化と簡素化された抗生物質予防を強調しています. ほとんどの症例は処置に関係なく,勧告では,リスクの高い患者に抗生物質の予防が 필요할 때를明確にしています.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症は感染症です.
- 公衆衛生は公衆衛生である.
背景:
- バクテリア性内心炎の予防に関するガイドラインは,最後に1990年に更新されました.
- リスクのある個人は,病気の予防のための最新の勧告を必要とします.
研究 の 目的:
- バクテリア性心臓内膜炎を予防するためのアメリカ心臓協会の推奨事項を更新します.
- リスクのある個人や医療従事者に明確なガイドラインを提供すること.
主な方法:
- 内心炎の専門知識を持つ執筆グループと,関連する専門団体からの連絡メンバーが招集されました.
- 勧告は,文献レビュー,インビトロデータ,動物研究,およびヒト症例の遡及的分析に基づいています.
- MEDLINEの検索 (1936年-1996年) は,Endocarditis,bacteremia,および抗生物質予防というキーワードを使って行われました.
主要な成果:
- ほとんどの心内膜炎の症例は,侵襲的な処置とは関係ありません.
- 心臓病は,現在,高リスク,中リスク,軽微リスクのカテゴリーに分類されています.
- 予防療法を必要とする特定の手順は,口腔,歯科,胃腸,尿器系の手続きの簡素化された手順で明確化されています.
結論:
- 更新された勧告は,予防予防の徴候の明確性を向上させることを目的としています.
- 変更には,簡素化された投与,フォローアップ用量の除去,アレルギーのある個人に代替抗生物質が含まれています.
- 改訂は,医師と患者のコンプライアンスを強化し,コストを削減し,有害な影響を最小限に抑えることを目指しています.
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