在韩国，治疗非重症感染时，哪种方案更优，是万古霉素还是甲硝唑？
Which is the Preferred Regimen for Non-Severe Infection in Korea, Vancomycin or Metronidazole?
作者信息
Kim Jieun, Kim Jinyeong, Kim Bongyoung, Pai Hyunjoo
机构信息
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
出版信息
Infect Chemother. 2022 Jun;54(2):213-219. doi: 10.3947/ic.2022.0027. Epub 2022 May 30.
Abstract
The emergence of hypervirulent strains has decreased the efficacy of metronidazole in the treatment of infection (CDI). Therefore, revised guidelines no longer recommend the use of metronidazole as a first-line regimen for CDI and restrict its use for non-severe CDI, only when vancomycin and fidaxomicin are unavailable. In Korea, an epidemic caused by a hypervirulent strain or the emergence of metronidazole resistant strains have not been reported. This review article aims to compare the treatment outcomes and adverse effects of vancomycin and metronidazole and discuss the validity of the guidelines of various agencies, which restrict the use of metronidazole, for Korean patients. There are no substantial adverse effects of metronidazole, and its clinical outcomes against non-severe CDI are similar to those of vancomycin. Based on these findings, we recommend that the use of metronidazole for the treatment of non-severe CDI is still an appropriate option in Korea.
摘要
高毒力菌株的出现降低了甲硝唑治疗艰难梭菌感染（CDI）的疗效。因此，修订后的指南不再推荐将甲硝唑用作CDI的一线治疗方案，仅在万古霉素和非达霉素无法获得时，才将其用于非重症CDI。在韩国，尚未报告由高毒力菌株引起的疫情或甲硝唑耐药菌株的出现。这篇综述文章旨在比较万古霉素和甲硝唑的治疗效果及不良反应，并讨论各机构限制甲硝唑使用的指南对韩国患者的有效性。甲硝唑没有实质性的不良反应，其针对非重症CDI的临床结果与万古霉素相似。基于这些发现，我们建议在韩国，使用甲硝唑治疗非重症CDI仍是一个合适的选择。
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