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アミノグリコシド系薬使用症例に対する抗菌薬TDMガイドライン2016に基づいた薬剤師介入の評価
https://gifu-pu.repo.nii.ac.jp/records/13727
https://gifu-pu.repo.nii.ac.jp/records/1372727b3676c-9ea3-43e7-b793-289d65c703af
| Item type | 研究室原著論文(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2020-03-04 | |||||
| タイトル | ||||||
| タイトル | アミノグリコシド系薬使用症例に対する抗菌薬TDMガイドライン2016に基づいた薬剤師介入の評価 | |||||
| タイトル | ||||||
| タイトル | patient with renal failure| anticancer drug eliminated through the kidney| dose reduction criteria| gimeracil/tegaful/oteracil potassium (S-1)| adjuvant chemotherapy | |||||
| 言語 | en | |||||
| 言語 | ||||||
| 言語 | jpn | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | *Amikacin(毒性・副作用,治療的利用,血液) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | *Gentamicins(毒性・副作用,治療的利用,血液) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | *Tobramycin(毒性・副作用,治療的利用,血液) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 細菌感染症(薬物療法) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 腎臓疾患(化学的誘発) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 発生率 | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | *病院薬局業務 | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 診療ガイドライン | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 後向き研究 | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 治療成績 | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | *ドラッグモニタリング | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | ヒト | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 中年(45〜64) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 高齢者(65〜79) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 高齢者(80〜) | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 男 | |||||
| キーワード | ||||||
| 主題Scheme | Other | |||||
| 主題 | 女 | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | aminoglycosides | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | therapeutic drug monitoring | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | amikacin | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | gentamicin | |||||
| キーワード | ||||||
| 言語 | en | |||||
| 主題Scheme | Other | |||||
| 主題 | tobramycin | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
| 資源タイプ | journal article | |||||
| アクセス権 | ||||||
| アクセス権 | metadata only access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_14cb | |||||
| 抄録 | ||||||
| 値 | Aminoglycoside drugs (AGs) are recommended for therapeutic drug monitoring (TDM) to ensure safety and efficacy. However, in Japan there are few institutions engaged in TDM intervention for AGs in all cases. Antibacterial drug TDM guideline 2016 was announced in August 2016, AGs' TDM is expected to become popular and contribute to proper use, but there are still few reports on its usefulness. From August 1, 2016, our hospital monitors the prescription of AGs from board certified infection control pharmacy specialist, and designed the initial administration design based on the guidelines, and established a system to consult with the doctor in charge. In addition, intervention was made on the future administration method from the blood concentration measurement result. After that, we investigated the influence on the clinic by retrospectively investigating 2 years before and after the intervention as target period. 84 subjects before intervention and 68 subjects after intervention were included, and the breakdown of each AGs was not significant. The cases in which the blood concentration was measured increased significantly from 42.9% before intervention to 60.3% after intervention. In addition, the median number of blood concentration measurements significantly increased from 0 before intervention to 1 after intervention. Target blood concentration achievement rate increased significantly from 9.5% before intervention to 35% after intervention. The median number of days to blood concentration measurement was significantly shortened from 5 days before intervention to 3 days after intervention among patients who had blood concentration measurement. The incidence of renal failure significantly decreased from 15.5% before intervention to 2.9%, but the 30-day mortality rate did not change. Among 15 patients with renal disorder, 12 cases were elderly people aged 70 years or older, and 7 cases were patients whose initial trough concentration exceeded the target value. Blood concentrations in 3 cases were not measured. From the above, it was suggested that intervention by pharmacists based on guidelines could reduce the incidence of renal failure through proper use of AGs. |
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| 書誌情報 |
医療薬学 巻 45, 号 11, p. 638-648, 発行日 2019-11 |
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