頁籤選單縮合
題名 | 治療困難梭狀桿菌感染之復發=Treatment of Recurrent Clostridium Difficile Infection |
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作者 | 張婷雅; 王春玉; Chang, Ting-ya; Wang, Chun-yu; |
期刊 | 藥學雜誌 |
出版日期 | 20130600 |
卷期 | 29:2=115 2013.06[民102.06] |
頁次 | 頁72-75 |
分類號 | 419.38 |
語文 | chi |
關鍵詞 | 困難梭狀桿菌; 頑固性困難梭狀桿菌感染; 反覆腹瀉; Clostridium difficile; Vancomycin; Metronidazole; |
中文摘要 | 困難梭狀桿菌 (Clostridium difficile) 感染的發生率自2000年開始上升,其復發率和死亡率高而且不易治療成功,造成復發可能的機轉是腸道正常菌叢的破壞,以及宿主對於困難梭狀桿菌毒素的免疫力低下。其他危險因子包括年紀大、住院天數過長、長期使用抗生素。目前治療指引建議使用 metronidazole 或 vancomycin 治療第一次復發,對於第二次或多次復發的病人可以使用 vancomycin 漸減劑量式和脈衝性治療。其他藥品如益生菌、免疫球蛋白注射、rifaximin,尚待進一步的臨床研究。本文將探討頑固性困難梭狀桿菌感染復發的原因與治療。 |
英文摘要 | The incidence of Clostridium difficile infection (CDI) has been increasing in the world since 2000, recurrence and mortality rates are high and it is difficult to be treated successfully. There is strong evidence favoring alteration of the fecal microbiota and poor immunization to toxoids as major contributors to the recurrence of CDI. Other risk factors include old age, prolonged hospital course and antibiotic use. Current guidelines recommend that patients with first time recurrence to receive metronidazole or vancomycin. Vancomycin tapered therapy or pulse therapy are recommended as first-line therapy for second time recurrence or more recurrences. Other treatments include adjunct probiotics, IVIg, rifaximin are needed to be proved. Recurrent CDI is a challenge to treat. This review discusses the various therapeutic approaches used for the treatment of refractory and recurrent CDI. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。