急性鼻副鼻腔炎診療 ... - jrs.umin.jp

1 2013 1 Common disease opinion leader HP 2 2 12 22 6 2 3 12 25 7 3 2 0 1 0 1.

2 52 .. 53 .. 54 .. 65 .. 66 .. 67 .. 68 .. 79 .. 710 .. 81 2 3 11 .. 1612 .. 1613 .. 17CQ13-1 CQ13-1A CQ13-1B HS CQ13-2 HS CQ13-3 CQ13-4 CQ13-5 CQ13-6 CQ13-7 CQ13-8 4 14.

3 32CQ14-1 CQ14-2 CQ14-2A - CQ14-2B CQ14-2C CQ14-3 CQ14-4 CQ14-4A CQ14-4B CQ14-4C CQ14-4D 15 .. 47CQ15-1 CQ15-1A CQ15-1B CQ15-1C CQ15-2 CQ15-2A CQ15-2B CQ15-2C CQ15-3 CQ15-3A CQ15-3B Abstract Table.

4 59 5 1 clinical question 2009 2 12 2

5 3 Conflict of Interest 50 6 MSD 4 5 1 2 clinical question 2009 6 7 15 16 1 2 7 8

6 4 acute sinusitis acute rhinosinusitis 1 3 sinusitis 4 4 1 Meltzer EO, Hamilos DL, Hadley JA, et al. Rhinosinusitis: establishing definitions for clinical research and patient care. Otolaryngol Head Neck Surg 2004; 131 (Suppl): Rosenfeld RM, Andes D, Bhattacharyya N, et al.

7 Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg 2007; 137 (Suppl): Fokkens W, Lund V, Mullol J. European Position Paper on rhinosinusitis and polyps. Rhinol 2007; (Suppl): Slavin RG, Spector SL, Bernstein IL, et al. The diagnosis and management of sinusitis: a practice parameter up-date. J Allergy Clin Immunol 2005; 116 (Suppl 6): PSSP Penicillin susceptible Streptococcus pneumoniae PISP Penicillin intermediately resistant Streptococcus pneumoniae PRSP Penicillin resistant Streptococcus pneumoniae 1998 NCCLS Minimal lnhibitory Concentration: MIC PSSP MIC PISP MIC MIC 2mg/mL CLSI 2008 1 MIC 1998 Clinical and Laboratory Standards Institute.

8 Performance Standards for Antimicrobial Susceptibility Testing: Eighteenth Informational Supplement 2008; M100-S18 Vol. 28 (No. 1): 126-7. 8 1 MIC MIC 2 MIC 2mg/mL MIC 4mg/mL MIC 8mg/mL 3 MIC MIC MIC 2mg/mL BLNAS - -lactamase non-producing ampicillin susceptible BLNAR - -lactamase non-producing ampicillin resistant BLPAR - -lactamase producing ampicillin resistant BLPACR - -lactamase producing ampicillin clavulanate resistant Haemophilus influenzae - ampicillin ABPC - BLNAR BLNAR PBP3

9 3 1 2 Low BLNAR High BLNAR BLNAR Low BLNAR 1mg 2mg/mL 5 BLNAR 4mg/mL Low BLNAR 2mg/mL - - BLPAR 10 1 1 1997 131 2 2 6 a 2 1998 11 1999 3 4 415 NCCLS CLSI MIC 93 PSSP PISP PRSP 81 BLNAS BLNAR BLPAR 1 2000; 93 (4): 283-9.

10 9 2 3 PCG 4 ABPC 5 PCG 10 6 ABPC 1 2007 11 b 3 2003 1 2003 5 5 303 5 NCCLS CLSI MIC 89 PSSP PISP PRSP 55 BLNAS BLNAR BLPAR c 4 2007 1 2007 6 6 1 5 134 5 0% 78 PSSP PISP PRSP 63 BLNAS BLNAR BLPAR 2 2007 12 3 2007 4 2007 5 2007 13 1 2 2000; 18: 3 2004; 22: 4 2008; 26: 15-26.