Earticle

초록

영어

Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients (65≤age<80) and oldest-old patients (80≤age) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.

목차

ABSTRACT
연구 방법
연구대상 및 자료수집
호전군과 비호전군 분류
환자의 CDI 중증도 판정
통계분석
연구 결과
노인층 환자군의 특성
호전군과 비호전군 비교
노인환자 CDI 비호전군의 영향인자
Metronidazole과 vancomycin의 약물사용평가
고찰 및 결론
감사의 글
참고문헌

키워드

저자

• 노현정 [ Hyun Jeong Noh | 이화여자대학교 임상보건융합대학원, 강북삼성병원 약제부 ]
• 함정연 [ Jung Yeon Ham | 강북삼성병원 약제부 ]
• 이자균 [ Ja Gyun Lee | 강북삼성병원 약제부 ]
• 이정연 [ Sandy Jeong Rhie | 이화여자대학교 임상보건융합대학원, 이화여자대학교 약학대학 및 대학원생명약학부 ] Corresponding Author

참고문헌

발행기관

간행물

표지보기 관심저널 등록

• 간행물명

  한국임상약학회지 [Korean Journal of Clinical Pharmacy]

• 간기

  계간

• pISSN

  1226-6051

• 수록기간

  1991~2026

• 등재여부

  KCI 등재

• 십진분류

  KDC 518 DDC 615