ログイン
ランキング
お知らせ
ログイン
文献詳細
特集 抗菌薬の選択と上手な使い方！—私の処方箋
文献概要
要旨 急性単純性膀胱炎は性的活動期の女性に多く発症し，治療薬としてキノロン系薬，セフェム系薬が推奨される。閉経前と閉経後の女性では原因菌の分布と薬剤感受性パターンが異なること，妊婦では腎盂腎炎を発症するリスクと胎児への影響などそれぞれの患者背景を理解しなければならない。また，原因菌として最も高頻度のEscherichia coli では，10％前後でセフェム系薬やキノロン系薬に耐性，約5％は基質特異性拡張型βラクタマーゼ（ESBL）産生株であり，薬剤耐性菌の増加傾向を認識する必要がある。したがって，急性単純性膀胱炎の治療では患者背景と原因菌の薬剤感受性を考慮し，最も適切な抗菌薬を選択する。
参考文献
1）Matsumoto T, Hamasuna R, Ishikawa K, et al：Nationwide survey of antibacterial activity 499 against clinical isolates from urinary tract infections in Japan（2008）. Int J Antimicrob Agents 37：210-218, 2011
. J Infect Chemother 19：393-403, 2013
3）Schito GC, Naber KG, Botto H, et al：The ARESC study：an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract infections. Int J Antimicrob. Agents 34：407-413, 2009
from community-acquired urinary tract infections in Europe：the ECO・SENS study revisited. Int J Antimicrob Agents 39：45-51, 2012
5）Kahlmeter G：An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections：the ECO. SENS Project. J Antimicrob Chemother 51：69-76, 2003
6）Lee SJ, Lee SD, Cho IR, et al：Antimicrobial susceptibility of uropathogens causing acute uncomplicated cystitis in female outpatients in South Korea：a multicentre study in 2002. Int J Antimicrob Agents 24：S61-64, 2004
7）Kim ME, Ha US and Cho YH：Prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in female outpatients in South Korea：a multicentre study in 2006. Int J Antimicrob Agents 31：S15-18, 2008
8）Ho PL, Yip KS, Chow KH, et al：Antimicrobial resistance among uropathogens that cause acute uncomplicated cystitis in women in Hong Kong：a prospective multicenter study in 2006 to 2008. Diagn Microbiol Infec Dis 66：87-93, 2010
9）Muratani T and Matsumoto T：Bacterial resistance to antimicrobials in urinary isolates. Int J Antimicrob Agents 24：S28-31, 2004
10）Gupta K, Hooton TM, Naber KG, et al：International clinical practice guidelines for the treatment of acute uncomplicated cystitis and acute pyelonephritis in women. A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 52：103-120, 2011
11）Grabe M, Bjerklund-Johansen TE, Bartoletti R, et al：Guidelines on urological infections. European Association of Urology, 2014
12）JAID/JSC感染症治療ガイド・ガイドライン作成委員会（編）：JAID/JSC感染症治療ガイド2014．ライフサイエンス出版，東京，pp203-205，2014
. JAMA 250：3063-3066, 1983
14）Nicolle LE, Madsen KS, Debeeck GO, et al：Three days of pivmecillinam or norfloxacin for treatment of acute uncomplicated urinary infection in women. Scand J Infect Dis 34：487-492, 2002
15）Sanchez GV, Adams SJ, Baird AM, et al：Escherichia coli antimicrobial resistance increased faster among geriatric outpatients compared with adult outpatients in the USA, 2000-10. J Antimicrob Chemother 68：1838-1841, 2013
16）Prabhu A, Taylor P, Konecny P, et al：Pyelonephritis：What are the present day causative organisms and antibiotic susceptibilities? Nephrology 18：463-467, 2013
17）van Haarst EP, van Andel G, Heldeweg EA, et al：Evaluation of the diagnostic workup in young women referred for recurrent lower urinary tract infections. Urology 57：1068-1072, 2001
18）Smaill F：Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev 2：CD000490, 2001
19）Matsumoto T, Muratani T, Nakahama C, et al：Clinical effects of 2 days of treatment by fosfomycin calcium for acute uncomplicated cystitis in women. J Infect Chemother 17：80-86, 2011
20）Hamasuna R, Tanaka K, Hayami H, et al：Treatment of acute uncomplicated cystitis with faropenem for 3 days versus 7 days：multicentre, randomized, open-label, controlled trial. J Antimicrob Chemother 69：1675-1680, 2014
21）Takahashi S, Hamasuna R, Yasuda M, et al：A randomized clinical trial to evaluate the preventive effect of cranberry juice（UR65）for patients with recurrent urinary tract infection. J Infect Chemother 19：112-117, 2013
掲載誌情報
