{"id":1325,"date":"2017-05-24T10:18:39","date_gmt":"2017-05-24T01:18:39","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1325"},"modified":"2017-05-24T10:18:39","modified_gmt":"2017-05-24T01:18:39","slug":"%e7%b5%82%e6%9c%ab%e6%9c%9f%e7%b7%a9%e5%92%8c%e3%82%b1%e3%82%a2%e6%82%a3%e8%80%85%e3%81%ae%e6%84%9f%e6%9f%93%e7%97%87%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e6%8a%97%e8%8f%8c%e8%96%ac%e3%81%ae%e4%bd%bf","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1325","title":{"rendered":"\u7d42\u672b\u671f\u7de9\u548c\u30b1\u30a2\u60a3\u8005\u306e\u611f\u67d3\u75c7\u306b\u5bfe\u3059\u308b\u6297\u83cc\u85ac\u306e\u4f7f\u7528\u306b\u3064\u3044\u3066"},"content":{"rendered":"

\u2015\u6587\u732e\u540d\u2015
\nJoseph H. Rosenberg, Jennifer S. Albrecht, Erik K. Fromme, et al. Antimicrobial Use for Symptom Management in Patients Receiving Hospice and Palliative Care: A Systematic Review
\nJ Palliat Med. 2013 Dec 1; 16(12): 1568\u20131574<\/p>\n

\u2015\u8981\u7d04\u2015
\nIntroduction<\/strong>
\n\u3000\u7c73\u56fd\u3067\u3082\u9ad8\u9f62\u5316\u306b\u3088\u308a\u7de9\u548c\u30b1\u30a2\u306e\u5fc5\u8981\u6027\u304c\u9ad8\u307e\u3063\u3066\u3044\u308b\u3002\u7d42\u672b\u671f\u60a3\u8005\u306f\u9ad8\u3044\u611f\u67d3\u306e\u30ea\u30b9\u30af\u304c\u3042\u308a\u3001\u7d0427%\u306e\u60a3\u8005\u304c\u6b7b\u4ea1\u3059\u308b\u9031\u306b\u6297\u83cc\u85ac\u304c\u6295\u4e0e\u3055\u308c\u3066\u3044\u308b\u3002\u3053\u306e\u72b6\u6cc1\u306b\u3082\u95a2\u308f\u3089\u305a\u7d42\u672b\u671f\u60a3\u8005\u306b\u304a\u3051\u308b\u6297\u83cc\u85ac\u306e\u6295\u4e0e\u304c\u3001\u4e88\u5f8c\u306e\u5ef6\u9577\u3068\u75c7\u72b6\u7de9\u548c\u306b\u5bc4\u4e0e\u3059\u308b\u304b\u306b\u3064\u3044\u3066\u306f\u660e\u3089\u304b\u3067\u306f\u306a\u3044\u30022002\u5e74\u306b\u7d42\u672b\u671f\u60a3\u8005\u306b\u5bfe\u3059\u308b\u611f\u67d3\u306eSystematic\u3000Review\u304c\u3042\u3063\u305f\u304c\u3001\u305d\u306e\u4e2d\u3067\u306f\u75c7\u72b6\u306e\u6539\u5584\u306b\u95a2\u3059\u308b\u8ad6\u6587\u306f1\u3064\u3060\u3051\u3067\u3042\u3063\u305f\u3002\u3053\u306e10\u5e74\u3067\u7d42\u672b\u671f\u60a3\u8005\u306b\u304a\u3051\u308b\u6297\u83cc\u85ac\u306e\u4f7f\u7528\u3092\u691c\u8a0e\u3059\u308b\u3044\u304f\u3064\u304b\u306e\u8ad6\u6587\u304c\u767a\u8868\u3055\u308c\u3066\u3044\u308b\u3002\u4eca\u56de\u306f\u305d\u308c\u3089\u306e\u6587\u732e\u3092\u4f53\u7cfb\u7684\u306b\u30ec\u30d3\u30e5\u30fc\u3057\u3001\u75c7\u72b6\u306e\u6539\u5584\u306b\u5bfe\u3059\u308b\u65e2\u5b58\u306e\u30c7\u30fc\u30bf\u3092\u8981\u7d04\u3057\u305f\u3002\u3053\u308c\u306b\u3088\u308a\u4eca\u5f8c\u306e\u7d42\u672b\u671f\u60a3\u8005\u306e\u6297\u83cc\u6295\u4e0e\u306e\u6709\u7121\u306e\u5224\u65ad\u306b\u3064\u3044\u3066\u5f79\u7acb\u3066\u308b\u3053\u3068\u304c\u76ee\u7684\u3067\u3042\u308b\u3002<\/p>\n

Method<\/strong>
\n\u3000PubMed\u30672001\u5e741\u67081\u65e5\uff5e2011\u5e746\u670830\u65e5\u307e\u3067\u306e\u9593\u306b\u767a\u8868\u3055\u308c\u305f\u7d42\u672b\u671f\u60a3\u8005\u306e\u6297\u83cc\u85ac\u4f7f\u7528\u306b\u3064\u3044\u3066\u306e\u6587\u732e\u306eSystematic\u3000Review\u3067\u3042\u308a\u3001palliative care\u3001infection \u3001antibiotic\u7b49\u306e\u6587\u5b57\u3067\u691c\u7d22\u3057\u305f\u3002\u764c\u3092\u542b\u3080\u7d42\u672b\u671f\u60a3\u8005\u306b\u304a\u3051\u308b\u3001\u6297\u83cc\u85ac\u4f7f\u7528\u7387\u3068\u4f7f\u7528\u5f8c\u306e\u75c7\u72b6\u306e\u6539\u5584\u3092\u6e2c\u5b9a\u3057\u305f\u6587\u732e\u306b\u9650\u5b9a\u3057\u3066\u5206\u6790\u3057\u305f\u3002\u5275\u50b7\u3001\u53e3\u8154\u30b1\u30a2\u3001\u885b\u751f\u74b0\u5883\u3001\u85ac\u7269\u52d5\u614b\u306b\u7126\u70b9\u3092\u5f53\u3066\u305f\u3082\u306e\u306f\u9664\u5916\u3068\u3057\u3066\u3044\u308b\u3002\u5bfe\u8c61\u3068\u3057\u3066\u3044\u308b\u8ad6\u6587\u306f\u8a18\u8ff0\u7814\u7a76\u3067\u3042\u308b\u3002\u30c7\u30fc\u30bf\u30d9\u30fc\u30b9\u4ee5\u5916\u306e\u691c\u7d22\u306f\u3057\u3066\u304a\u3089\u305a\u3001funnel plot\u306a\u3057\u3002\u6587\u732e\u306e\u8a55\u4fa1\u306b\u3064\u3044\u3066\u306f\u30011\u4eba\u76ee\u306e\u8457\u8005\u306f\u6587\u732e\u304c\u57fa\u6e96\u3092\u6e80\u305f\u3057\u3066\u3044\u308b\u306e\u304b\u3092\u8a55\u4fa1\u3057\u30012\u4eba\u76ee\u30013\u4eba\u76ee\u306e\u8457\u8005\u304c\u9078\u3070\u308c\u305f\u6587\u732e\u3092\u30ec\u30d3\u30e5\u30fc\u3057\u30014\u4eba\u76ee\u306e\u8457\u8005\u304c\u8a55\u4fa1\u8005\u306e\u5185\u5bb9\u306b\u504f\u308a\u304c\u306a\u3044\u304b\u30c1\u30a7\u30c3\u30af\u3057\u3066\u3044\u308b\u3002<\/p>\n

Results<\/strong>
\n\u3000PubMed\u3067984\u306e\u6587\u732e\u3092\u691c\u7d22\u3057\u3001\u57fa\u6e96\u3092\u6e80\u305f\u3059\u6587\u732e\u306f11\u500b\u3067\u3042\u3063\u305f\u3002table1\u306f\u60a3\u8005\u6570\u3001\u4e3b\u75c5\u540d\u3001\u7642\u990a\u74b0\u5883\u3001\u56fd\u3001\u7814\u7a76\u65b9\u6cd5\u3001\u53cd\u5fdc\u6027\u3001\u6297\u83cc\u85ac\u4f7f\u7528\u7387\u306b\u3064\u3044\u3066\u8a18\u8f09\u3057\u3066\u3044\u308b\u3002table2\u306f\u6297\u83cc\u85ac\u306b\u5bfe\u3059\u308b\u75c7\u72b6\u306e\u6539\u5584\u306b\u3064\u3044\u3066\u8a18\u8f09\u3055\u308c\u3066\u304a\u308a8\u500b\u306e\u6587\u732e\u304c\u5f53\u3066\u306f\u307e\u3063\u3066\u3044\u308b\u3002\u5168\u4f53\u3067\u306e\u6297\u83cc\u85ac\u306b\u3088\u308b\u6cbb\u7642\u306e\u52b9\u679c\u306b\u3064\u3044\u3066\u306f\u300121.4\uff05(95\uff05CI:13.2\uff05\uff0d31.7\uff05\uff09\uff5e56.7\uff05\uff0895\uff05CI:52.7\uff05\uff0d60.6\uff05\uff09\u3068\u69d8\u3005\u3067\u3042\u3063\u305f\u3002\u70b9\u6ef4\u6295\u4e0e\u306e\u307f\u306e\u7814\u7a76\u306f2\u3064\u3042\u308a\u3001\u52b9\u679c\u306f\u305d\u308c\u305e\u308c52.9\uff05(95\uff05Cl27.8\uff5e77.0%)\u300175.9%(95%Cl:52.7~60.6%)\u3067\u3042\u3063\u305f\u3002\u307e\u305f\u81d3\u5668\u5225\u306e\u6297\u83cc\u85ac\u306e\u52b9\u679c\u306b\u3064\u3044\u3066\u8a18\u8f09\u3055\u308c\u305f\u8ad6\u6587\u304c3\u3064\u3042\u308a\u3001\u305d\u306e\u4e2d\u306e2\u3064\u306e\u6587\u732e\u306b\u3088\u308b\u3068\u5c3f\u8def\u611f\u67d3\u75c7\u3067\u306f60~92%\u3001\u547c\u5438\u5668\u611f\u67d3\u75c7\u3067\u306f0~53%\u3001\u83cc\u8840\u75c7\u3067\u306f0%\u306e\u52b9\u679c\u3067\u3042\u3063\u305f\u3002<\/p>\n

Discussion<\/strong>
\n\u3000\u4eca\u56de\u306e\u7814\u7a76\u306e\u8ab2\u984c\u3068\u3057\u3066\u306f\u3001\u6297\u83cc\u85ac\u4f7f\u7528\u7fa4\u3068\u975e\u4f7f\u7528\u7fa4\u3068\u306e\u6bd4\u8f03\u5bfe\u7167\u3057\u305f\u7814\u7a76\u3067\u306f\u306a\u3044\u3002\u6297\u83cc\u85ac\u306e\u4f7f\u7528\u72b6\u6cc1\u3068\u75c7\u72b6\u306e\u6539\u5584\u3092\u540c\u6642\u306b\u6e2c\u5b9a\u3057\u3066\u3044\u308b\u4e8b\u306b\u7570\u8cea\u6027\u304c\u3042\u308b\u3002\u73fe\u6642\u70b9\u3067\u306f\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306e\u7814\u7a76\u306f\u306a\u3044\u3002\u75c7\u72b6\u306e\u6539\u5584\u3068\u3044\u3046\u70b9\u3067\u3082\u6709\u52b9\u306a\u75c7\u72b6\u6e2c\u5b9a\u30c4\u30fc\u30eb\u3092\u4f7f\u7528\u3057\u3066\u304a\u3089\u305a\u3001\u4e3b\u89b3\u7684\u306a\u8a55\u4fa1\u3092\u7528\u3044\u3066\u3044\u308b(\u305f\u3060\u3001\u75c7\u72b6\u306e\u8a55\u4fa1\u81ea\u4f53\u304c\u4e3b\u89b3\u7684\u3067\u3042\u308a\u6e2c\u5b9a\u304c\u96e3\u3057\u3044)\u3002\u89e3\u71b1\u5264\u7b49\u306e\u6297\u83cc\u85ac\u4ee5\u5916\u306e\u6cbb\u7642\u306e\u52b9\u679c\u304c\u9664\u5916\u3055\u308c\u3066\u3044\u306a\u3044\u306e\u3067\u3001\u6297\u83cc\u85ac\u306e\u72ec\u7acb\u3057\u305f\u52b9\u679c\u304b\u306f\u4e0d\u660e\u3002\u6297\u83cc\u85ac\u306e\u526f\u4f5c\u7528\u306b\u3064\u3044\u3066\u3082\u8003\u616e\u3057\u3066\u3044\u306a\u3044\u3002
\n\u30db\u30b9\u30d4\u30b9\u3067\u306f\u611f\u67d3\u75c7\u306e\u8a3a\u65ad\u81ea\u4f53\u304c\u3042\u3044\u307e\u3044\u306a\u5834\u5408\u304c\u591a\u3044\u3002\u4eca\u56de\u306e\u7814\u7a76\u3067\u306f\u6570\u304c\u9650\u3089\u308c\u3066\u3044\u308b\u305f\u3081
\n\u30d5\u30a1\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u3092\u7528\u3044\u305f\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u306e\u8a55\u4fa1\u3082\u884c\u308f\u306a\u304b\u3063\u305f\u3002
\n\u4eca\u56de\u306e\u7814\u7a76\u7d50\u679c\u306f\u3053\u306e\u5206\u91ce\u306b\u304a\u3051\u308b\u8cea\u306e\u9ad8\u3044\u7814\u7a76\u306e\u5fc5\u8981\u6027\u3092\u518d\u78ba\u8a8d\u3059\u308b\u3082\u306e\u3067\u3042\u3063\u305f\u3002
\n\u4eca\u5f8c\u7814\u7a76\u3092\u884c\u3046\u969b\u306f\u3001\u6709\u52b9\u306a\u75c7\u72b6\u6e2c\u5b9a\u30c4\u30fc\u30eb\u3092\u6d3b\u7528\u3059\u308b\u3002\u6297\u83cc\u85ac\u6cbb\u7642\u7fa4\u3068\u975e\u6cbb\u7642\u7fa4\u3068\u3092\u5206\u3051\u3066\u8a55\u4fa1\u3059\u308b\u3002\u611f\u67d3\u75c7\u3092\u5b9a\u7fa9\u4ed8\u3051\u308b\u3002\u526f\u4f5c\u7528\u3082\u8abf\u67fb\u3059\u308b\u3002\u4ed6\u306e\u85ac\u5264\u4f7f\u7528\u7b49\u306e\u75c7\u72b6\u7ba1\u7406\u72b6\u6cc1\u306e\u4ea4\u7d61\u56e0\u5b50\u3092\u304d\u3061\u3093\u3068\u9664\u3044\u305f\u30d7\u30ed\u30b9\u30da\u30af\u30c6\u30a3\u30d6\u306a\u7814\u7a76\u304c\u5fc5\u8981\u3067\u3042\u308b\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n\u30002017\u5e745\u670824\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u2015\u6587\u732e\u540d\u2015 Joseph H. Rosenberg, Jennifer S. Albrecht, Erik K. Fromme, et al. Antimicrobial Use for Symptom Manageme … \u7d9a\u304d\u3092\u8aad\u3080 \u7d42\u672b\u671f\u7de9\u548c\u30b1\u30a2\u60a3\u8005\u306e\u611f\u67d3\u75c7\u306b\u5bfe\u3059\u308b\u6297\u83cc\u85ac\u306e\u4f7f\u7528\u306b\u3064\u3044\u3066<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-1325","post","type-post","status-publish","format-standard","hentry","category-12"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1325","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1325"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1325\/revisions"}],"predecessor-version":[{"id":1326,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1325\/revisions\/1326"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1325"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1325"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1325"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}