ํก์ธ์„ฑ ํ๋ ด ํ•ญ์ƒ์ œ / Aspiration pneumonia antibiotics

์ •์˜

ํก์ธ์„ฑ ํ๋ ด์€ ๊ตฌ๊ฐ•/์œ„ ๋‚ด์šฉ๋ฌผ ํก์ธ ํ›„ ๋ฐœ์ƒํ•˜๋Š” ํ ๊ฐ์—ผ์ด๋‹ค. Raw ์ž๋ฃŒ๋Š” ํก์ธ์„ฑ ํ๋ ด์—์„œ ์‚ฌ์šฉํ•  ์ˆ˜ ์žˆ๋Š” ํ•ญ์ƒ์ œ๊ตฐ์„ ๊ฐ„๋‹จํžˆ ์ œ์‹œํ•œ๋‹ค.

์ž„์ƒ ํ•ต์‹ฌ

Paper-only audit note: 2019 ATS/IDSA CAP guideline์€ suspected aspiration pneumonia์—์„œ ํ‘œ์ค€ CAP ๊ฒฝํ—˜์  ์น˜๋ฃŒ์— ํ˜๊ธฐ์„ฑ ์ปค๋ฒ„๋ฅผ routine์œผ๋กœ ์ถ”๊ฐ€ํ•˜์ง€ ๋ง ๊ฒƒ์„ ์ œ์•ˆํ•˜๋ฉฐ, lung abscess ๋˜๋Š” empyema๊ฐ€ ์˜์‹ฌ๋  ๋•Œ ์˜ˆ์™ธ์ ์œผ๋กœ ๊ณ ๋ คํ•˜๋„๋ก ํ•œ๋‹ค. ๋”ฐ๋ผ์„œ raw ์ž๋ฃŒ์˜ ampicillin-sulbactam, moxifloxacin 400 mg, carbapenem, clindamycin ๋ชฉ๋ก์€ ๋ณ‘์›/์ƒํ™ฉ๋ณ„ ํ›„๋ณด ๋˜๋Š” ์›์ž๋ฃŒ ๋ฉ”๋ชจ๋กœ๋งŒ ๋ณด๋ฉฐ, โ€œํก์ธ=ํ˜๊ธฐ์„ฑ ์ปค๋ฒ„/ํด๋ฆฐ๋‹ค๋งˆ์ด์‹ /์นด๋ฐ”ํŽ˜๋„ด routineโ€์œผ๋กœ ์‚ฌ์šฉํ•˜๋ฉด ์•ˆ ๋œ๋‹ค.

์ง„๋‹จ

์ž๋ฃŒ ๋‚ด์—๋Š” ์ง„๋‹จ ๊ธฐ์ค€์ด๋‚˜ ์˜์ƒ ์†Œ๊ฒฌ์€ ์ œ์‹œ๋˜์–ด ์žˆ์ง€ ์•Š๋‹ค. ์ž„์ƒ์ ์œผ๋กœ ํก์ธ ๋ณ‘๋ ฅ๊ณผ ํ๋ ด ์†Œ๊ฒฌ์ด ์žˆ์„ ๋•Œ ํ•ญ์ƒ์ œ ์„ ํƒ์— ๋ฐ˜์˜ํ•˜๋˜, aspiration pneumonitis์™€ ๊ฐ์—ผ์„ฑ ํ๋ ด์„ ๊ตฌ๋ถ„ํ•˜๊ณ  abscess/empyema ์—ฌ๋ถ€๋ฅผ ํ™•์ธํ•œ๋‹ค.

์น˜๋ฃŒ

ํ‘œ์ค€ CAP regimen์„ ๊ธฐ๋ณธ์œผ๋กœ ํ•˜๊ณ , ํ˜๊ธฐ์„ฑ ์ถ”๊ฐ€ ์ปค๋ฒ„๋Š” lung abscess/empyema ๋˜๋Š” ๋ช…ํ™•ํ•œ anaerobic infection ๋งฅ๋ฝ์—์„œ guideline/local protocol์— ๋”ฐ๋ผ ๊ฒฐ์ •ํ•œ๋‹ค. Raw ํ•ญ์ƒ์ œ๋ช…๊ณผ ์šฉ๋Ÿ‰(moxifloxacin 400 mg, carbapenem, clindamycin ๋“ฑ)์€ paper-only ๊ฒ€์ฆ ์ „ ํ™•์ • ๊ถŒ๊ณ ๋‚˜ ๊ธฐ๋ณธ ์ฒ˜๋ฐฉ์œผ๋กœ ์“ฐ์ง€ ์•Š๋Š”๋‹ค.

์ถœ์ฒ˜

๐ŸŒฑ ์ถœ์ฒ˜ raw


๋ณธ ๋ฌธ์„œ๋Š” ํ•™์Šตยท์ฐธ๊ณ ์šฉ์ด๋ฉฐ ์‹ค์ œ ์ง„๋ฃŒ ๊ฒฐ์ •์€ ์ž„์ƒ์˜์˜ ํŒ๋‹จ์ž…๋‹ˆ๋‹ค.