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https://hdl.handle.net/20.500.14094/90007068

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メタデータID
90007068
アクセス権
open access
出版タイプ
Accepted Manuscript
タイトル
Antibiotic de-escalation therapy in patients with community-acquired nonbacteremic pneumococcal pneumonia
著者
Uda, Atsushi ; Tokimatsu, Issei ; Koike, Chihiro ; Osawa, Kayo ; Shigemura, Katsumi ; Kimura, Takeshi ; Miyara, Takayuki ; Yano, Ikuko
著者名
Uda, Atsushi
著者ID
A0057
研究者ID
1000020347032
著者名
Tokimatsu, Issei
時松, 一成
トキマツ, イッセイ
所属機関名
医学部附属病院 感染制御部
著者名
Koike, Chihiro
著者ID
A0771
研究者ID
1000050324942
著者名
Osawa, Kayo
大澤, 佳代
オオサワ, カヨ
所属機関名
大学院保健学研究科 保健学専攻
著者ID
A1467
研究者ID
1000000457102
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=00a87f636663131d520e17560c007669
著者名
Shigemura, Katsumi
重村, 克巳
シゲムラ, カツミ
所属機関名
保健学研究科
著者名
Kimura, Takeshi
著者ID
A2427
研究者ID
1000050368304
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=138f2af1dd8a86c0520e17560c007669
著者名
Miyara, Takayuki
宮良, 高維
ミヤラ, タカユキ
所属機関名
医学部附属病院
著者ID
A0421
研究者ID
1000050273446
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=c67473c1ec5daab2520e17560c007669
著者名
Yano, Ikuko
矢野, 育子
ヤノ, イクコ
所属機関名
医学部附属病院
言語
English (英語)
収録物名
International Journal of Clinical Pharmacy
巻(号)
41(6)
ページ
1611-1617
出版者
Springer
刊行日
2019-12
公開日
2021-01-01
抄録
Background De-escalation therapy is recommended as an effective antibiotic treatment strategy for several infectious diseases. While there is limited evidence supporting its clinical and cost-effective outcomes in patients with community-acquired bacteremic pneumonia, there is no evidence in patients with nonbacteremic pneumonia. Objective This study aimed to evaluate the antibiotic costs in patients who did and did not receive de-escalation therapy, based on the 2017 Japanese guidelines for the management of community-acquired nonbacteremic pneumococcal pneumonia of the Japanese Respiratory Society (JRS). Setting Kobe university hospital, Japan. Methods A retrospective case series review including antibiotic use and length of hospital stay was conducted using the medical records from April 2008 to May 2019 at a university hospital in Japan. Main outcome measure Impact of antibiotic de-escalation therapy on the antibiotic costs. Results Among 55 patients who were eligible, the treating physicians de-escalated antibiotics in 28 (51%). The differences in the median length of hospital stay and the incidence of adverse drug reactions between the two groups were not statistically significant (p = 0.67 and 1.0, respectively). However, the median total antibiotic cost per infected patient in the de-escalated group was significantly lower than that in the non-de-escalated group [$269.8 ($195-$389) vs. $420.5 ($221-$799), p = 0.048]. Conclusion Antibiotic de-escalation based on the 2017 JRS guidelines leads to a reduction in total antibiotic costs for the management of community-acquired nonbacteremic pneumococcal pneumonia.
キーワード
Antibiotic cost
Antibiotic de-escalation therapy
Community-acquired pneumococcal pneumonia
Japan
JRS Pneumonia Guidelines
カテゴリ
医学部附属病院
保健学研究科
学術雑誌論文
権利
© Springer Nature Switzerland AG 2019. This is a post-peer-review, pre-copyedit version of an article published in International Journal of Clinical Pharmacy. The final authenticated version is available online at: https://doi.org/10.1007/s11096-019-00926-z
関連情報
DOI
https://doi.org/10.1007/s11096-019-00926-z