臨床検査57巻10号

2013年10月発行

今月の特集2 Clostridium difficile感染症

Clostridium difficile感染症の治療と予防

著者： 平井潤¹² 浜田幸宏² 山岸由佳¹² 三鴨廣繁¹²³

所属機関： ¹愛知医科大学病院感染症科 ²愛知医科大学病院感染制御部 ³愛知医科大学大学院医学研究科臨床感染症学

ページ範囲：P.1125 - P.1132

■Clostridium difficile感染症（CDI）の治療抗菌薬として，軽症例や初回の再発例ではメトロニダゾール（MNZ），重症例や再発を繰り返す例ではバンコマイシン（VCM）が推奨される．

■プロバイオティクスによるCDIの予防は確立しているとは言い難いが，有用性が報告されているため併用を考慮する．また，プレバイオティクスとの併用も検討する．

■フィダキソマイシン（FDX）はC. difficileのRNA polymeraseを阻害することにより殺菌的に作用する薬剤で，正常な腸内細菌叢を破壊しにくく，C. difficileの芽胞形成抑制作用や毒素産生抑制作用も認められる．VCMと比較してCDIの再発率が低く，VREなどの耐性菌出現のリスクも低いことから，新たな治療選択肢として注目される．

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