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내과계 중환자실 재원 성인 환자의 Clostridium difficile associated Diarrhea에 대한 Metronidazole과 Vancomycin의 치료효과 비교
A Comparison of Vancomycin and Metronidazole for the Treatment of Clostridium difficile-associated Diarrhea (CDAD) in Medical Intensive Care Unit (MICU)
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- 발행기관
- 한국임상약학회 바로가기
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- 간행물
- 한국임상약학회지 KCI 등재 바로가기
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- 통권
- 제27권 제2호 (2017.06)바로가기
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- 페이지
- pp.77-82
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- 저자
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- 언어
- 한국어(KOR)
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- URL
- https://www.earticle.net/Article/A311811
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원문정보
초록
- 영어
- Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or H2 blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.
목차
ABSTRACT
연구 방법
연구 대상
연구 방법
통계 분석
피험자 보호
연구 결과
연구 대상자의 일반적 특성
고찰
결론
참고문헌
키워드
Clostridium difficile associated diarrhea metronidazole vancomycin medical intensive care unit (micu)저자
간행물 정보
발행기관
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- 발행기관명
- 한국임상약학회 [Korean College of Clinical Pharmacy]
- 설립연도
- 1
- 분야
- 의약학>약학
- 소개
- 합리적 약물치료(rational pharmacotherapy)의 보장 및 증진을 궁극목적으로 하며 이를 달성하기 위해 임상약학의 발전과 회원 상호간의 친목을 도모한다.
간행물
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- 간행물명
- 한국임상약학회지 [Korean Journal of Clinical Pharmacy]
- 간기
- 계간
- pISSN
- 1226-6051
- 수록기간
- 1991~2026
- 등재여부
- KCI 등재
- 십진분류
- KDC 518 DDC 615
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