ÀÓ»óÁú¹® | ´ç´¢º´È¯ÀÚÀÇ ¹ß °¨¿°Ä¡·áÁ¦ÀÎ ¾îŸÆä³Û(ertapenem)°ú ¹ÝÄÚ¸¶À̽Å(vancomycin)¿¡ ´ëÇÑ È¿°ú¸¦ ºñ±³ÇÑ ¿¬±¸°¡ ÀÖ½À´Ï±î? |
±Ù°Å±â¹Ý ´äº¯ | ¾îŸÆä³Û(ertapenem)À» ´Üµ¶ ȤÀº ¹ÝÄÚ¸¶À̽Å(vancomycin)°ú º´Çà Ä¡·áÇϸé Ƽ°Ô»çÀÌŬ¸°(tigecycline)º¸´Ù È¿°úÀûÀÎ °ÍÀ¸·Î ³ªÅ¸³µ½À´Ï´Ù. (RR 0.92, 95% confidence interval (CI) 0.85 to 0.99; 955 participants). |
¼ÁöÁ¤º¸ | Systemic antibiotics for treating diabetic foot infections. Selva Olid A1, Solà I, Barajas-Nava LA, Gianneo OD, Bonfill Cosp X, Lipsky BA. Cochrane Database Syst Rev. 2015 Sep 4;(9):CD009061. doi: 10.1002/14651858.CD009061.pub2. |
¿¬±¸¸ñÀû | ´ç´¢º´ ¹ß°¨¿°¿¡ ¿©·¯ °¡Áö Àü½Å Ç×»ýÁ¦³ª ±¹¼Ò Ç×»ýÁ¦ È¿°ú ºñ±³ |
¿¬±¸¼³°è | 20 trials with 3791 Âü°¡ÀÚ : ü°èÀû ¹®Çå°íÂû(Systematic Review)°ú ¸ÞŸºÐ¼® |
Áúȯ ¹× ¿¬±¸´ë»ó | ÃÑ 1,945¸íÀÇ ºñ¸¸¼ºÀÎÀÌ 12ÁÖ-13ÁÖ µ¿¾È Âü°¡ÇÏ¿´À½ |
½ÃÇ豺 ÁßÀç | 1) anti-pseudomonal penicillins (three trials); 2) broad-spectrum penicillins (one trial); 3) cephalosporins (two trials); 4) carbapenems (four trials); 5) fluoroquinolones (six trials); 6) other antibiotics (four trials). |
´ëÁ¶±º ÁßÀç | ¿©·¯ °¡Áö Àü½Å Ç×»ýÁ¦³ª ±¹¼Ò Ç×»ýÁ¦ È¿°ú¸¦ ¼·Î ºñ±³Çϰųª Çö󼼺¸(placebo)¿Í ºñ±³ÇÑ ¹«ÀÛÀ§´ëÁ¶±º½ÇÇè(RCTs)À» 2015³â 3¿ù±îÁö °Ë»ö |
Æò°¡ÁöÇ¥ | - ±Þ¼º °¨¿°¿¡ ´ëÇÑ Áõ»ó¿ÏÈÀÇ Â¡ÈÄ¿Í Áõ»ó - °¨¿° Ä¡·á±â°£ - Ç×»ýÁ¦ Ä¡·á ºÎÀÛ¿ë(Allergic reactions, organ toxicity, intolerance, etc.) - °¨¿°À¸·Î ÀÎÇÑ ÇÕº´Áõ |
ÁÖ¿ä°á°ú | -DaptomycinÀº ¹ÝÄÚ¸¶À̽Å(vancomycin)À̳ª ´Ù¸¥ ÇÕ¼ºÆä´Ï½Ç¸° Ç×»ýÁ¦º¸´Ù ÀûÀº ºÎÀÛ¿ëÀÌ ³ªÅ¸³µÀ½À» º¸°í ÇÔ. -LinezolidÀº Ampicillin-sulbactam º¸´Ù Á»´õ µ¶¼ºÀÌ ÀÖ´Â °ÍÀ¸·Î ³ªÅ¸³². ´ç´¢º´È¯ÀÚÀÇ ¹ß °¨¿° Ä¡·á¿¡ ¿©·¯ °¡Áö ´Ù¸¥ Àü½Å Ç×»ýÁ¦ ÀÇ »ó´ëÀû È¿°ú¿¡ ´ëÇÑ Áõ°Å´Â ¸®ºä ´ë»ó ½ÇÇ迬±¸µé »çÀÌ¿¡ ÆíÂ÷°¡ ¸Å¿ì Å©°í ¹ÙÀ̾(bias)ÀÇ À§ÇèÀÌ ³ô°Å³ª ºÒ¸íÈ®Çß½À´Ï´Ù. µû¶ó¼ ¾î¶² ÇÑ °¡Áö Ç×»ýÁ¦°¡ ´Ù¸¥ Ç×»ýÁ¦º¸´Ù °¨¿° Çؼҳª ¾ÈÀü¼ºÀÇ ¸é¿¡¼ ´õ È¿°úÀûÀÎ °ÍÀ» ºÐ¸íÇÏ°Ô ¾Ë ¼ö ¾ø¾ú½À´Ï´Ù. ÇÑ °¡Áö ½ÇÇ迬±¸¿¡¼´Â ¾îŸÆä³Û(ertapenem)À» ´Üµ¶ ȤÀº ¹ÝÄÚ¸¶À̽Å(vancomycin)°ú º´Çà Ä¡·áÇϸé Ƽ°Ô»çÀÌŬ¸°(tigecycline)º¸´Ù È¿°úÀûÀÎ °ÍÀ¸·Î ³ªÅ¸³µ½À´Ï´Ù. ±× ¿ÜÀÇ ´Ù¸¥ Ç×»ýÁ¦µéÀÇ »ó´ëÀû È¿°ú´Â ºÒÈ®½ÇÇß½À´Ï´Ù. ¸®ºä ´ë»ó ½ÇÇ迬±¸µéÀÇ ¼³°è¿¡ ÇÑ°è°¡ ÀÖ°í, Æò°¡ Ç×»ýÁ¦ Á¾·ù¿Í Ä¡·á ±â°£, ±×¸®°í Æò°¡ ½Ã±â, µîÀÌ ´Ù¾çÇÏ¿© Áõ°ÅÀÇ ÁúÀº ³·°Ô Æò°¡µÇ¾ú½À´Ï´Ù. ¾ÕÀ¸·Î ÀÌ ºÐ¾ß¿¡¼ ½ÃÇàµÉ ½ÇÇ迬±¸´Â, ¼º°ú¸¦ Æò°¡¿¡ ¸Í°Ë¹ýÀ» Àû¿ëÇÏ°í, °¨¿°ÀÇ ÁßÁõµµ ºÐ·ù¿¡ Ç¥ÁØÈµÈ ±âÁØÀ» »ç¿ëÇϸç, ¼ºÀû ÁöÇ¥¿¡ ´ëÇÑ Á¤Àdzª Ä¡·á ±â°£À» ÅëÀÏÇØ¾ß ÇÒ °ÍÀÔ´Ï´Ù. |
±Ù°Å¼öÁØ | ³· À½(LOW) |
ÀÛ¼ºÀÚ | ÀÇ°úÇבּ¸Á¤º¸¼¾ÅÍ(MedRIC) |