アブストラクト

 
Japanese
Title :
下顎埋伏智歯抜歯術におけるセフカペンピボキシルとアモキシシリンの手術部位感染予防効果の比較
Subtitle :
一般論文
Authors :
山神彰1, 山田武宏1, 北川善政3, 大廣洋一4, 佐藤淳3,5, 石黒信久5, 今井俊吾1, 小林正紀1, 井関健1,2
Authors (kana) :
Organization :
1北海道大学病院薬剤部, 2北海道大学大学院薬学研究院臨床薬剤学研究室, 3北海道大学大学院歯学研究院口腔診断内科学教室, 4北海道大学大学院歯学研究院口腔顎顔面外科学教室, 5北海道大学病院感染制御部
Journal :
医療薬学
Volume :
45
Number :
5
Page :
254-261
Year/Month :
2019 / 5
Article :
報告
Publisher :
日本医療薬学会
Abstract :
「緒言」抗菌薬が効かなくなる薬剤耐性 (antimicrobial resistance : AMR) が拡大している一方で, その抗菌薬開発は近年停滞しており, 薬剤耐性菌の発現を防ぐことが急務となっている. このような状況に対応するため, わが国では2016年4月, 厚生労働省よりAMR対策アクションプラン2016-2020 (http://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/0000120769.pdf, 2018年5月20日) が発表された. 同アクションプランによると, 諸外国に比して経口第三世代セファロスポリン系薬など広域抗菌薬の使用量が多いことから, その使用量を削減することが成果指標に示された. 経口第三世代セファロスポリン系抗菌薬は, 歯科領域において手術部位感染 (surgical site infection : SSI) 予防に使用されてきた.
Practice :
薬学
Keywords :
cefcapene-pivoxil, amoxicillin, surgical site infection, impacted mandibular third molar surgery, antimicrobial resistance
  
English
Title :
Comparison between the Prophylactic Effects of Cefcapene-pivoxil and Amoxicillin on Surgical Site Infection after Impacted Mandibular Third Molar Surgery
Subtitle :
Regular Articles
Authors :
Akira Yamagami1, Takehiro Yamada1, Yoshimasa Kitagawa3, Yoichi Ohiro4, Jun Sato3,5, Nobuhisa Ishiguro5, Shungo Imai1, Masaki Kobayashi1, Ken Iseki1,2
Authors (kana) :
Organization :
1Department of Pharmacy, Hokkaido University Hospital, 2Laboratory of Clinical Pharmaceutics & Therapeutics, Division of Pharmasciences, Faculty of Pharmaceutical Sciences, Hokkaido University, 3Oral Diagnosis and Medicine, Graduate School of Dental Medicine, Hokkaido University, 4Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, 5Division of Infection Control and Prevention, Hokkaido University Hospital
Journal :
Japanese Journal of Pharmaceutical Health Care and Sciences
Volume :
45
Number :
5
Page :
254-261
Year/Month :
2019 / 5
Article :
Report
Publisher :
Japanese Society of Pharmaceutical Health Care and Sciences
Abstract :
Third-generation oral cephalosporins are broad-spectrum antimicrobial agents and constitute one of the most used antibiotic classes in Japan. In the "National Action Plan on Antimicrobial Resistance (AMR)," the Japanese government declared implementation of efforts to reduce the use of oral cephalosporins by 50% by 2020, compared to 2013. Antimicrobial resistance generally occurs due to inappropriate use or low-dosage exposure to antibiotic agents. Therefore, the choice of appropriate antibiotics is essential for implementing antimicrobial stewardship. To evaluate the prophylactic effects of antibiotics in impacted mandibular third molar surgery, we compared the rate of surgical site infection (SSI) in patients who were administered cefcapene-pivoxil (CFPN-PI) orally with that in patients who received amoxicillin (AMPC) orally. We conducted a retrospective study by reviewing the medical charts of patients from Hokkaido University Hospital from April 2016 to March 2017. The patients evaluated were classified into two groups : the AMPC group (n = 164) and the CFPN-PI group (n = 129). The SSI ratio of the CFPN-PI group was significantly higher than that of the AMPC group (CFPN-PI group, 11.6% (15/129) ; AMPC group, 2.4% (4/164) ; P = 0.002). Multivariate logistic regression analysis demonstrated that "use of CFPN-PI for prophylactic treatment" and "hospitalization after surgery" were independent factors related to the onset of SSI following impacted mandibular third molar surgery. These results demonstrated that AMPC was more effective than CFPN-PI in the prevention of SSI after impacted mandibular third molar surgery, and its regulated dosage can effectively contribute to the optimal use of antimicrobial prophylactic treatment.
Practice :
Pharmaceutical sciences
Keywords :
cefcapene-pivoxil, amoxicillin, surgical site infection, impacted mandibular third molar surgery, antimicrobial resistance
  

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