medicina59巻7号

2022年06月発行

特集 抗菌薬の使い方—敵はコロナだけにあらず！ 今こそ基本に立ち返る 感染症サイドから考える抗菌薬の使い方—症例をもとに

上気道感染症，下気道感染症

著者： 野田晃成¹ 皿谷健¹

所属機関： ¹杏林大学医学部付属病院呼吸器内科

ページ範囲：P.1104 - P.1109

Point
◎風邪の「典型」を知り，「典型」から外れる場合は診断に慎重になる．
◎新型コロナウイルス感染症（COVID-19）流行期で施行の機会が減っているが，グラム染色は肺炎診療に有効である．
◎COVID-19肺炎において軽症例では抗菌薬は必要ないことが多いが，重症例では細菌感染の合併や二次感染に注意する．
◎COVID-19に関連した侵襲性肺アスペルギルス症について知識を深める．

参考文献

1）Bennett JE, et al（eds）：Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 8th ed., pp 748-752.e2., Elsevier, Amsterdam, 2015

2）Del Rio-Pertuz G, et al：Usefulness of sputum gram stain for etiologic diagnosis in community-acquired pneumonia；A systematic review and meta-analysis. BMC Infect Dis 19：403, 2019

3）NICE：COVID-19 rapid guideline：managing COVID-19, NICE guideline［NG191］, 2021　https://www.nice.org.uk/guidance/ng191（2022年3月閲覧）

4）Farrell JM, et al：Causes and consequences of COVID-19-associated bacterial infections. Front Microbiol 12：682571, 2021

5）Rawson TM,et al：Bacterial and fungal coinfection in individuals with coronavirus；A rapid review to support COVID-19 antimicrobial prescribing. Clin Infect Dis 71：2459-2468, 2020

6）Baghdadi JD,et al：Antibiotic use and bacterial infection among inpatients in the first wave of COVID-19；A retrospective cohort study of 64,691 patients. Antimicrob Agents Chemother 65：e0134121, 2021

7）Chen N, et al：Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China；A descriptive study. Lancet 395：507-513, 2020

8）Chen S, et al：Rotavirus infection and cytopathogenesis in human biliary organoids potentially recapitulate biliary atresia development. mBio 11：e01968-20, 2020

9）He S,et al：Clinical characteristics of COVID-19 patients with clinically diagnosed bacterial co-infection；A multi-center study. PLoS One 16：e0249668, 2021

10）Koehler P, et al：Defining and managing COVID-19-associated pulmonary aspergillosis；The 2020 ECMM/ISHAM consensus criteria for research and clinical guidance. Lancet Infect Dis 21：e149-e162, 2021

11）Takazono T, et al：COVID-19 associated pulmonary aspergillosis；A nationwide survey by the Japanese Respiratory Society. ERJ Open Res 7：00402-2021, 2021