TG13：胆道炎抗菌薬治療の国際的な特徴と推奨診断
要旨：Tokyo Guidelines 2007（TG 07）における胆道炎の抗菌薬に関する推奨事項を再検討し，新しい知見や新薬に関する情報を統合した新しい国際ガイドラインTG 13が2013年に発表，策定された。現在，TG 13が直面する代表的な課題は以下である。1．耐性菌の蔓延率が地域により大きく異なるため，地域の感受性パターンに準拠したガイドラインが必要であること，2．急性胆管炎・胆囊炎の患者に対して，血液培養は，アウトカムを変えるのか。3．血流感染を伴う胆管炎・胆囊炎では，治療期間はどのくらい必要か。4．腸球菌はどの患者に対して抗菌薬での治療対象とすべきか。5．嫌気性菌は，どの患者に対...
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| Published in | 日本腹部救急医学会雑誌 Vol. 34; no. 3; pp. 653 - 658 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本腹部救急医学会
2014
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1340-2242 1882-4781 |
| DOI | 10.11231/jaem.34.653 |
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| Abstract | 要旨：Tokyo Guidelines 2007（TG 07）における胆道炎の抗菌薬に関する推奨事項を再検討し，新しい知見や新薬に関する情報を統合した新しい国際ガイドラインTG 13が2013年に発表，策定された。現在，TG 13が直面する代表的な課題は以下である。1．耐性菌の蔓延率が地域により大きく異なるため，地域の感受性パターンに準拠したガイドラインが必要であること，2．急性胆管炎・胆囊炎の患者に対して，血液培養は，アウトカムを変えるのか。3．血流感染を伴う胆管炎・胆囊炎では，治療期間はどのくらい必要か。4．腸球菌はどの患者に対して抗菌薬での治療対象とすべきか。5．嫌気性菌は，どの患者に対して抗菌薬で治療対象とすべきか。6．待機的Endoscopic retrograde cholangiopancreatography （ERCP）の予防投与薬は何が最適なのか。今後TG 13は，よりよいガイドラインへとさらに進化・発展するサイクルをつくる必要がある。 |
|---|---|
| AbstractList | 要旨：Tokyo Guidelines 2007（TG 07）における胆道炎の抗菌薬に関する推奨事項を再検討し，新しい知見や新薬に関する情報を統合した新しい国際ガイドラインTG 13が2013年に発表，策定された。現在，TG 13が直面する代表的な課題は以下である。1．耐性菌の蔓延率が地域により大きく異なるため，地域の感受性パターンに準拠したガイドラインが必要であること，2．急性胆管炎・胆囊炎の患者に対して，血液培養は，アウトカムを変えるのか。3．血流感染を伴う胆管炎・胆囊炎では，治療期間はどのくらい必要か。4．腸球菌はどの患者に対して抗菌薬での治療対象とすべきか。5．嫌気性菌は，どの患者に対して抗菌薬で治療対象とすべきか。6．待機的Endoscopic retrograde cholangiopancreatography （ERCP）の予防投与薬は何が最適なのか。今後TG 13は，よりよいガイドラインへとさらに進化・発展するサイクルをつくる必要がある。 |
| Author | 高田, 忠敬 矢野, 晴美 |
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| References | 10) Hsueh P-R, Badal RE, Hawser SP, et al: Epidemiology and antimicrobial susceptibility profiles of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region: 2008 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). Int J Antimicrob Agents 2010; 36: 408-414. 15) Paterson DL: Resistance in gram-negative bacteria: Enterobacteriaceae. Am J Infect Control 2006; 34: S20-S28. 4) Dellinger RP, Levy MM, Carlet JM, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008; 36: 296-327. 23) Maluenda F, Csendes A, Burdiles P, et al: Bacteriological study of choledochal bile in patients with common bile duct stones, with or without acute suppurative cholangitis. Hepatogastroenterology 1989; 36: 132-135. 1) Gomi H, Solomkin JS, Takada T, et al: TG13 antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2013; 20: 60-70. 20) Csendes A, Becerra M, Burdiles P, et al: Bacteriological studies of bile from the gallbladder in patients with carcinoma of the gallbladder, cholelithiasis, common bile duct stones and no gallstones disease. Eur J Surg 1994; 160: 363-367. 18) Kune G, Schutz E: Bacteria in the biliary tract. A study of their frequency and type. Med J Aust 1974; 1: 255-258. 24) Chang W, Lee K, Wang S, et al: Bacteriology and antimicrobial susceptibility in biliary tract disease: an audit of 10-year's experience. Kaohsiung J Med Sci 2002; 18: 221-228. 8) Rossi F, Baquero F, Hsueh P-R, et al: In vitro susceptibilities of aerobic and facultatively anaerobic Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). J Antimicrob Chemother 2006; 58: 205-210. 7) Paterson DL, Rossi F, Baquero F, et al: In vitro susceptibilities of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: the 2003 Study for Monitoring Antimicrobial Resistance Trends (SMART). J Antimicrob Chemother 2005; 55: 965-973. 27) Melzer M, Toner R, Lacey S, et al: Biliary tract infection and bacteremia: presentation, structural abnormalities, causative organisms and clinical outcomes. Postgrad Med J 2007; 83: 773-776. (level C 11) Chen Y-H, Hsueh P-R, Badal RE, et al: Antimicrobial susceptibility profiles of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region according to currently established susceptibility interpretive criteria. J Infect 2011; 62: 280-291. 2) Tanaka A, Takada T, Kawarada Y, et al: Antimicrobial therapy for acute cholangitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007; 14: 59-67. 12) Ishii Y, Tateda K, Yamaguchi K: Evaluation of antimicrobial susceptibility for β-lactams using the E test method against clinical isolates from 100 medical centers in Japan (2006). Diagn Microbiol Infect Dis 2008; 60: 177-183. 22) Csendes A, Mitru N, Maluenda F, et al: Counts of bacteria and pyocites of choledochal bile in controls and in patients with gallstones or common bile duct stones with or without acute cholangitis. Hepatogastroenterology 1996; 43: 800-806. 6) Solomkin JS, Mazuski JE, Bradley JS, et al: Diagnosis and management of complicated Intra-abdominal infection in adults and children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010; 50: 133-164. 13) Ishii Y, Ueda C, Kouyama Y, et al: Evaluation of antimicrobial susceptibility for β-lactams against clinical isolates from 51 medical centers in Japan (2008). Diagn Microbiol Infect Dis 2011; 69: 443-448. 17) Kang CI, Cheong H, Chung D, et al: Clinical features and outcome of community-onset bloodstream infections caused by extended-spectrum β-lactamase-producing Escherichia coli. Eur J Clin Microb Infect Dis 2008; 27: 85-88. 5) Dellinger RP, Levy MM, Rhodes A, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2012; 41: 580-637. 9) Yang Q, Wang H, Chen M, et al: Surveillance of antimicrobial susceptibility of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in China: the 2002-2009 Study for Monitoring Antimicrobial Resistance Trends (SMART). Int J Antimicrob Agents 2010; 36: 507-512. 25) Salvador V, Lozada M, Consunji R: Microbiology and antibiotic susceptibility of organisms in bile cultures from patients with and without cholangitis at an Asian Academic Medical Center. Surg Infect 2011; 12: 105-111. 3) Yoshida M, Takada T, Kawarada Y, et al: Antimicrobial therapy for acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007; 14: 83-90. 16) Choi SH, Lee J, Park S, et al: Prevalence, microbiology, and clinical characteristics of extended-spectrum; beta-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii and & Morganella morganii in Korea. Eur J Clin Microb Infect Dis 2007; 26: 557-561. 28) Lee C-C, Chang IJ, Lai Y-C, et al: Epidemiology and prognostic determinants of patients with bacteremic cholecystitis or cholangitis. Am J Gastroenterol 2007; 102: 563-569. 14) Sung YK, Lee JK, Lee KH, et al: The Clinical epidemiology and outcomes of bacteremic biliary tract infections caused by antimicrobial-resistant pathogens. Am J Gastroenterol 2012; 107: 473-483. 19) Csendes A, Fernandez M, Uribe P: Bacteriology of the gallbladder bile in normal subjects. Am J Surg 1975; 129: 629-631. 21) Csendes A, Burdiles P, Maluenda F, et al: Simultaneous bacteriologic assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones. Arch Surg 1996; 131: 389-394. 26) Kuo CH CC, Chen JJ, Tai DI, et al: Septic acute cholecystitis. Scand J Gastroenterol 1995; 30: 272-275. 29) Brand M, Bizs D, O'Farrell PJR: Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography (review). Cochrane Database Syst Rev. 2010 Oct 6; (10): CD007345. |
| References_xml | – reference: 7) Paterson DL, Rossi F, Baquero F, et al: In vitro susceptibilities of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: the 2003 Study for Monitoring Antimicrobial Resistance Trends (SMART). J Antimicrob Chemother 2005; 55: 965-973. – reference: 8) Rossi F, Baquero F, Hsueh P-R, et al: In vitro susceptibilities of aerobic and facultatively anaerobic Gram-negative bacilli isolated from patients with intra-abdominal infections worldwide: 2004 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). J Antimicrob Chemother 2006; 58: 205-210. – reference: 19) Csendes A, Fernandez M, Uribe P: Bacteriology of the gallbladder bile in normal subjects. Am J Surg 1975; 129: 629-631. – reference: 21) Csendes A, Burdiles P, Maluenda F, et al: Simultaneous bacteriologic assessment of bile from gallbladder and common bile duct in control subjects and patients with gallstones and common duct stones. Arch Surg 1996; 131: 389-394. – reference: 29) Brand M, Bizs D, O'Farrell PJR: Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography (review). Cochrane Database Syst Rev. 2010 Oct 6; (10): CD007345. – reference: 13) Ishii Y, Ueda C, Kouyama Y, et al: Evaluation of antimicrobial susceptibility for β-lactams against clinical isolates from 51 medical centers in Japan (2008). Diagn Microbiol Infect Dis 2011; 69: 443-448. – reference: 25) Salvador V, Lozada M, Consunji R: Microbiology and antibiotic susceptibility of organisms in bile cultures from patients with and without cholangitis at an Asian Academic Medical Center. Surg Infect 2011; 12: 105-111. – reference: 15) Paterson DL: Resistance in gram-negative bacteria: Enterobacteriaceae. Am J Infect Control 2006; 34: S20-S28. – reference: 16) Choi SH, Lee J, Park S, et al: Prevalence, microbiology, and clinical characteristics of extended-spectrum; beta-lactamase-producing Enterobacter spp., Serratia marcescens, Citrobacter freundii and & Morganella morganii in Korea. Eur J Clin Microb Infect Dis 2007; 26: 557-561. – reference: 4) Dellinger RP, Levy MM, Carlet JM, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008; 36: 296-327. – reference: 26) Kuo CH CC, Chen JJ, Tai DI, et al: Septic acute cholecystitis. Scand J Gastroenterol 1995; 30: 272-275. – reference: 6) Solomkin JS, Mazuski JE, Bradley JS, et al: Diagnosis and management of complicated Intra-abdominal infection in adults and children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis 2010; 50: 133-164. – reference: 11) Chen Y-H, Hsueh P-R, Badal RE, et al: Antimicrobial susceptibility profiles of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region according to currently established susceptibility interpretive criteria. J Infect 2011; 62: 280-291. – reference: 3) Yoshida M, Takada T, Kawarada Y, et al: Antimicrobial therapy for acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007; 14: 83-90. – reference: 23) Maluenda F, Csendes A, Burdiles P, et al: Bacteriological study of choledochal bile in patients with common bile duct stones, with or without acute suppurative cholangitis. Hepatogastroenterology 1989; 36: 132-135. – reference: 24) Chang W, Lee K, Wang S, et al: Bacteriology and antimicrobial susceptibility in biliary tract disease: an audit of 10-year's experience. Kaohsiung J Med Sci 2002; 18: 221-228. – reference: 20) Csendes A, Becerra M, Burdiles P, et al: Bacteriological studies of bile from the gallbladder in patients with carcinoma of the gallbladder, cholelithiasis, common bile duct stones and no gallstones disease. Eur J Surg 1994; 160: 363-367. – reference: 22) Csendes A, Mitru N, Maluenda F, et al: Counts of bacteria and pyocites of choledochal bile in controls and in patients with gallstones or common bile duct stones with or without acute cholangitis. Hepatogastroenterology 1996; 43: 800-806. – reference: 2) Tanaka A, Takada T, Kawarada Y, et al: Antimicrobial therapy for acute cholangitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg 2007; 14: 59-67. – reference: 14) Sung YK, Lee JK, Lee KH, et al: The Clinical epidemiology and outcomes of bacteremic biliary tract infections caused by antimicrobial-resistant pathogens. Am J Gastroenterol 2012; 107: 473-483. – reference: 28) Lee C-C, Chang IJ, Lai Y-C, et al: Epidemiology and prognostic determinants of patients with bacteremic cholecystitis or cholangitis. Am J Gastroenterol 2007; 102: 563-569. – reference: 9) Yang Q, Wang H, Chen M, et al: Surveillance of antimicrobial susceptibility of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in China: the 2002-2009 Study for Monitoring Antimicrobial Resistance Trends (SMART). Int J Antimicrob Agents 2010; 36: 507-512. – reference: 1) Gomi H, Solomkin JS, Takada T, et al: TG13 antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2013; 20: 60-70. – reference: 10) Hsueh P-R, Badal RE, Hawser SP, et al: Epidemiology and antimicrobial susceptibility profiles of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region: 2008 results from SMART (Study for Monitoring Antimicrobial Resistance Trends). Int J Antimicrob Agents 2010; 36: 408-414. – reference: 27) Melzer M, Toner R, Lacey S, et al: Biliary tract infection and bacteremia: presentation, structural abnormalities, causative organisms and clinical outcomes. Postgrad Med J 2007; 83: 773-776. (level C) – reference: 12) Ishii Y, Tateda K, Yamaguchi K: Evaluation of antimicrobial susceptibility for β-lactams using the E test method against clinical isolates from 100 medical centers in Japan (2006). Diagn Microbiol Infect Dis 2008; 60: 177-183. – reference: 18) Kune G, Schutz E: Bacteria in the biliary tract. A study of their frequency and type. Med J Aust 1974; 1: 255-258. – reference: 5) Dellinger RP, Levy MM, Rhodes A, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2012; 41: 580-637. – reference: 17) Kang CI, Cheong H, Chung D, et al: Clinical features and outcome of community-onset bloodstream infections caused by extended-spectrum β-lactamase-producing Escherichia coli. Eur J Clin Microb Infect Dis 2008; 27: 85-88. |
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| Snippet | 要旨：Tokyo Guidelines 2007（TG 07）における胆道炎の抗菌薬に関する推奨事項を再検討し，新しい知見や新薬に関する情報を統合した新しい国際ガイドラインTG 13が2013年に発表，策定された。現在，TG... |
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| Title | TG13：胆道炎抗菌薬治療の国際的な特徴と推奨診断 |
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| ispartofPNX | 日本腹部救急医学会雑誌, 2014/03/31, Vol.34(3), pp.653-658 |
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