[보충] 담도계 감염의 항생제 요법

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[보충] 담도계 감염의 항생제 요법

[보충] 담도계 감염의 항생제 요법

2018년 개정발표된 도쿄 가이드라인(Tokyo guidelines)(TG18)에서 제시한 항생제 요법을 소개하고자 한다.

증증도

Community-acquired biliary infections

Healthcare-associated biliary

infections

Grade I

Grade II

Grade III

Penicillin 기반 

Ampicillin/sulbactamb is not recommended

if >20% resistance rate.

Piperacillin/tazobactam

Piperacillin/tazobactam

Piperacillin/tazobactam

Cephalosporin 기반

  • Cefazolin,
    or Cefotiam,
    or Cefuroxime,
    or Ceftriaxone,
    or Cefotaxime
    ± Metronidazole
  • Cefmetazole, Cefoxitin, Flomoxef, Cefoperazone/sulbactam
  • Ceftriaxone,
    or Cefotaxime,
    or Cefepime,
    or Cefozopran,
    or Ceftazidime
    ± Metronidazole
  • Cefoperazone/sulbactam
  • Cefepime,
    or Ceftazidime,
    or Cefozopran
    ± Metronidazole
  • Cefepime,
    or Ceftazidime,
    or Cefozopran
    ± Metronidazole

Carbapenem 기반

Ertapenem

Ertapenem

Imipenem/cilastatin, Meropenem, Doripenem, Ertapenem

Imipenem/cilastatin, Meropenem,

Doripenem, Ertapenem

Monobactam 기반

(-)

(-)

Aztreonam ± Metronidazole

Aztreonam ± Metronidazole

Fluoroquinolone 기반

  • Ciprofloxacin, Levofloxacin, Pazufloxacin ± Metronidazole
  • Moxifloxacin
  • Ciprofloxacin, Levofloxacin, Pazufloxacin
    ± Metronidazole
  • Moxifloxacin

(-)

(-)


 

참고자료

  • Gomi H, Solomkin JS, Schlossberg D, et al. Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2018;25(1):3–16.
 
 
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