p.63 抽出テキスト

癒率に差がない報告が増えてきた 24, 25)。しかし,敗血症における抗菌薬の治療期間に関する知見は確立していない。そこで,敗血症または集中治療を要する感染症のうち4 週間以上の長期治療を要するもの(心内膜炎,化膿性脊椎炎)を除いて,1 週間(8 日)以内の抗菌薬治療を1 週間(8 日)以上の抗菌薬治療と比較したRCT を対象にシステマティックレビューを行い,推奨文を作成した。

CQ4-11:腎排泄型の抗微生物薬の用量調整に際し

て,何が参考になるか?

敗血症患者では臓器障害として腎障害を生じることが多く,腎障害時には腎排泄型の抗微生物薬は用量調整を行う必要がある 15, 26-28)。この観点から,腎排泄型の抗微生物薬の用量調整に際して参考とすべき指標についてBQ として記述した。特に,1)腎機能の指標,2)分布容積の増加と血漿や細胞外液における抗微生物薬の希釈,3)腎クリアランスや体液量の変動, 4)体外膜型肺(extracorporeal membrane oxygenation: ECMO)や腎代替療法による影響に関する情報提供を行った。

文 献

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