{"id":1768,"date":"2019-10-18T17:29:38","date_gmt":"2019-10-18T08:29:38","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1768"},"modified":"2019-10-18T17:29:38","modified_gmt":"2019-10-18T08:29:38","slug":"a%e7%be%a4%e6%ba%b6%e9%80%a3%e8%8f%8c%e5%92%bd%e9%a0%ad%e7%82%8e%e3%81%b8%e3%81%ae5%e6%97%a5%e9%96%93%e3%81%ae%e6%8a%97%e7%94%9f%e5%89%a4%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1768","title":{"rendered":"A\u7fa4\u6eb6\u9023\u83cc\u54bd\u982d\u708e\u3078\u306e5\u65e5\u9593\u306e\u6297\u751f\u5264\u6cbb\u7642"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nGunilla Skoog Stahlgren, et al.Penicillin V four times daily for five days versus three times daily for 10 days in patients\u3000with pharyngotonsillitis caused by group A streptococci: randomized\u3000controlled, open label, non-inferiority study. BMJ\u30002019; 367:l5337<\/p>\n

\uff0d\u8981\u7d04\uff0d
\n\u3010Introduction\u3011
\n\u30b9\u30a6\u30a7\u30fc\u30c7\u30f3\u306b\u304a\u3044\u3066\u3001A\u7fa4\u6eb6\u9023\u83cc\u54bd\u982d\u708e\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u30ec\u30b8\u30e1\u30f3\u306f\u3001\u30da\u30cb\u30b7\u30ea\u30f3V 1000 mg\u30921\u65e53\u56de\u300110\u65e5\u9593\u3068\u306a\u3063\u3066\u3044\u308b\u3002\u3053\u306e\u6cbb\u7642\u671f\u9593\u306f\u4ed6\u306e\u56fd\u3068\u540c\u3058\u3060\u304c\u3001\u6295\u4e0e\u91cf\u3068\u7dcf\u66dd\u9732\u91cf\uff0830 g\uff09\u306f\u6bd4\u8f03\u7684\u591a\u3044\u3002
\n\u6297\u83cc\u85ac\u6cbb\u7642\u306e\u7406\u7531\u306f\u3001\u4e3b\u306b\u6025\u6027\u30ea\u30a6\u30de\u30c1\u71b1\u3084\u7cf8\u7403\u4f53\u814e\u708e\u306a\u3069\u306e\u91cd\u7be4\u306a\u5408\u4f75\u75c7\u3092\u907f\u3051\u308b\u305f\u3081\u3067\u3042\u308b\u304c\u3001\u3053\u308c\u3089\u306e\u72b6\u614b\u306f\u73fe\u5728\u3001\u9ad8\u6240\u5f97\u56fd\u3067\u306f\u975e\u5e38\u306b\u307e\u308c\u306a\u3082\u306e\u3068\u306a\u3063\u3066\u3044\u308b\u3002
\n\u4eca\u65e5\u3001\u9ad8\u6240\u5f97\u56fd\u3067\u306e\u6cbb\u7642\u306e\u4e3b\u306a\u7406\u7531\u306f\u901f\u3084\u304b\u306a\u75c7\u72b6\u306e\u81e8\u5e8a\u7684\u6cbb\u7652\u3092\u306f\u304b\u308b\u3053\u3068\u3067\u3042\u308a\u3001\u307e\u305f\u3001\u8179\u819c\u708e\u3001\u81bf\u75c2\u75b9\u3001\u8702\u5de3\u708e\u3001\u4e2d\u8033\u708e\u3001\u526f\u9f3b\u8154\u708e\u306a\u3069\u306e\u307e\u308c\u306a\u5408\u4f75\u75c7\u3092\u9632\u3050\u3053\u3068\u306b\u3082\u306a\u308b\u3002
\n2008\u5e74\u306e\u30e1\u30bf\u5206\u6790\u3067\u306f\u3001A\u7fa4\u30ec\u30f3\u30b5\u7403\u83cc\u54bd\u982d\u708e\u306e\u60a3\u8005\u3078\u3088\u308a\u77ed\u671f\u9593\u306e\u6cbb\u7642\uff085\uff5e7\u65e5\uff09\u3092\u884c\u3063\u305f\u5834\u5408\u300110\u65e5\u9593\u306e\u6cbb\u7642\u306b\u6bd4\u3079\u3066\u81e8\u5e8a\u7684\u6210\u529f\u3068\u7d30\u83cc\u5b66\u7684\u6839\u7d76\u306e\u53ef\u80fd\u6027\u304c\u4f4e\u3044\u3053\u3068\u304c\u793a\u3055\u308c\u305f\u3002
\n\u3053\u306e\u7814\u7a76\u3067\u306e1\u65e5\u7dcf\u6295\u4e0e\u91cf\u306f750\uff5e1600mg\u306e\u7bc4\u56f2\u3067\u30011\u65e52\u56de\u307e\u305f\u306f1\u65e53\u56de\u3060\u3063\u305f\u3002\u85ac\u7269\u52d5\u614b\u304a\u3088\u3073\u85ac\u529b\u5b66\u3068\u3057\u3066\u306f\u3001\u03b2\u30e9\u30af\u30bf\u30e0\u7cfb\u6297\u751f\u7269\u8cea\u306e\u6709\u52b9\u6027\u306f\u8840\u6e05\u4e2d\u306e\u975e\u7d50\u5408\u85ac\u7269\u6fc3\u5ea6\u306e\u6700\u5c0f\u963b\u5bb3\u6fc3\u5ea6\u3092\u8d85\u3048\u308b\u6642\u9593\u306b\u4f9d\u5b58\u3057\u3066\u304a\u308a\u3001\u305d\u306e\u6c7a\u5b9a\u8981\u56e0\u306f\u7528\u91cf\u3068\u6295\u85ac\u983b\u5ea6\u3067\u3042\u308b\u3002
\n1\u65e54\u56de800mg\u306e\u6295\u85ac\u30ec\u30b8\u30e1\u30f3\u306f\u30011\u65e53\u56de1000mg\u3068\u6bd4\u8f03\u3057\u3066\u3088\u308a\u826f\u3044\u3082\u306e\u3068\u306a\u308b\u3002\u77ed\u3044\u30ec\u30b8\u30e1\u30f3\u3067\u306e\u30ea\u30b9\u30af\u306f\u3001\u81e8\u5e8a\u7684\u6cbb\u7652\u3068\u5fae\u751f\u7269\u5b66\u7684\u6839\u7d76\u306e\u5272\u5408\u304c\u4f4e\u3044\u3053\u3068\u3060\u304c\u3001\u6cbb\u7642\u671f\u9593\u3092\u77ed\u7e2e\u3059\u308b\u3068\u526f\u4f5c\u7528\u304c\u5c11\u306a\u304f\u306a\u308a\u3001\u60a3\u8005\u306e\u30a2\u30c9\u30d2\u30a2\u30e9\u30f3\u30b9\u304c\u5411\u4e0a\u3057\u3001\u30d2\u30c8\u5fae\u751f\u7269\u53e2\u3078\u306e\u5f71\u97ff\u304c\u5c11\u306a\u304f\u306a\u308a\u3001\u6297\u751f\u7269\u8cea\u306e\u7dcf\u4f7f\u7528\u91cf\u3092\u6e1b\u3089\u3057\u3001\u60a3\u8005\u3068\u5730\u57df\u793e\u4f1a\u306e\u85ac\u7269\u8cbb\u7528\u3092\u524a\u6e1b\u3067\u304d\u308b\u3002
\n\u672c\u7814\u7a76\u306e\u76ee\u7684\u306f\u3001\u9069\u5207\u306a\u81e8\u5e8a\u52b9\u679c\u3092\u7dad\u6301\u3057\u306a\u304c\u3089\u3001\u30da\u30cb\u30b7\u30ea\u30f3V\u306e\u7dcf\u66b4\u9732\u91cf\u3092\u524a\u6e1b\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u3092\u8abf\u67fb\u3059\u308b\u3053\u3068\u3067\u3042\u308b\u3002A\u7fa4\u30ec\u30f3\u30b5\u7403\u83cc\u306b\u3088\u308b\u54bd\u982d\u6241\u6843\u708e\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u30da\u30cb\u30b7\u30ea\u30f3V800 mg 1\u65e54\u56de5\u65e5\u9593\u306e\u6cbb\u7642\u306f\u3001\u73fe\u5728\u306e\u63a8\u5968\u7528\u91cf\u3067\u3042\u308b1000 mg1\u65e53\u56de10\u65e5\u9593\u306b\u52a3\u3089\u306a\u3044\u3068\u3044\u3046\u4eee\u8aac\u306e\u3082\u3068\u3001\u975e\u52a3\u52e2\u8a66\u9a13\u3092\u884c\u3063\u305f\u3002<\/p>\n

\u3010Method\u3011
\n\u30c7\u30b6\u30a4\u30f3\uff1a\u30aa\u30fc\u30d7\u30f3\u30e9\u30d9\u30eb\u3001\u30e9\u30f3\u30c0\u30e0\u5316\u975e\u52a3\u52e2\u8a66\u9a13\u30022015\u5e749\u6708\uff5e2018\u5e742\u6708\u306e\u671f\u9593\u3001\u30b9\u30a6\u30a7\u30fc\u30c7\u30f3\u306e17\u306e\u533b\u7642\u30bb\u30f3\u30bf\u30fc\u306b\u3066\u5b9f\u65bd\u3002
\n\u5bfe\u8c61\uff1a6\u6b73\u4ee5\u4e0a\u3067\u30013\uff5e4\u306eCentor criteria\uff0838.5\u00b0C\u4ee5\u4e0a\u306e\u767a\u71b1\u3001\u30ea\u30f3\u30d1\u7bc0\u816b\u8139\u3001\u6241\u6843\u306e\u767d\u82d4\u3001\u54b3\u306e\u6b20\u5982\uff09\u3001\u304a\u3088\u3073A\u7fa4\u30ec\u30f3\u30b5\u7403\u83cc\u306e\u8fc5\u901f\u6297\u539f\u691c\u67fb\u967d\u6027\u3068\u306a\u3063\u305f\u60a3\u8005\u3092inclusion\u3002\u91cd\u75c5\u306e\u5146\u5019\u3092\u793a\u3057\u305f\u5834\u5408\u3001\u307e\u305f\u306f\u30da\u30cb\u30b7\u30ea\u30f3\u306b\u5bfe\u3059\u308b\u904e\u654f\u75c7\u3092\u6709\u3057\u3066\u3044\u305f\u5834\u5408\u3001\u5c11\u306a\u304f\u3068\u308215 mg\u306e\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u306b\u3088\u308b\u514d\u75ab\u8abf\u7bc0\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u305f\u5834\u5408\u3001\u904e\u53bb1\u30f6\u6708\u9593\u306b\u54bd\u982d\u6241\u6843\u708e\u306e\u6297\u751f\u7269\u8cea\u3092\u6295\u4e0e\u3055\u308c\u3066\u3044\u305f\u5834\u5408\uff08\u518d\u767a\uff09\u3001\u307e\u305f\u306finclusion\u304b\u308972\u6642\u9593\u4ee5\u5185\u306b\u6297\u751f\u7269\u8cea\u6cbb\u7642\u3092\u53d7\u3051\u305f\u5834\u5408\u306f\u9664\u5916\u3002
\n\u4ecb\u5165\uff1a\u30da\u30cb\u30b7\u30ea\u30f3V 800 mg\u30921\u65e54\u56de5\u65e5\u9593\u3001\u73fe\u5728\u306e\u63a8\u5968\u7528\u91cf1000 mg\u30921\u65e53\u56de10\u65e5\u9593\u3068\u6bd4\u8f03\u300240 kg\u307e\u3067\u306e\u5b50\u4f9b\u306f\u3001\u4f53\u91cd\u306b\u5fdc\u3058\u3066\u6295\u4e0e\u91cf\u3092\u8abf\u6574\u3057\u305f\uff0810-20 kg\uff1a\u6295\u4e0e\u91cf250 mg\u300120-40 kg\uff1a\u6295\u4e0e\u91cf500 mg\u3001\u6cbb\u7642\u7fa4\u306b\u95a2\u4fc2\u306a\u304f\uff09\u3002
\n\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\uff1a\u6297\u751f\u7269\u8cea\u6cbb\u7642\u306e\u7d42\u4e86\u5f8c5\u301c7\u65e5\u3067\u306e\u81e8\u5e8a\u7684\u6cbb\u7652\uff08\u4e3b\u8981\u306a\u6b8b\u5b58\u75c7\u72b6\u307e\u305f\u306f\u54bd\u982d\u6241\u6843\u708e\u307e\u305f\u306f\u75c7\u5019\u6027\u518d\u767a\u306e\u81e8\u5e8a\u6240\u898b\u306e\u306a\u3044\u5b8c\u5168\u306a\u56de\u5fa9\u3068\u3057\u3066\u5b9a\u7fa9\uff09\u3002\u4e8c\u6b21\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u3001\u6cbb\u7652\u8a66\u9a13\u3067\u63a1\u53d6\u3057\u305f\u57f9\u990a\u306b\u3088\u308b\u7d30\u83cc\u5b66\u7684\u6839\u7d76\u3001\u75c7\u72b6\u7de9\u548c\u307e\u3067\u306e\u6642\u9593\u3001\u518d\u767a\u306e\u983b\u5ea6\u3001\u5408\u4f75\u75c7\u304a\u3088\u3073\u65b0\u305f\u306a\u6241\u6843\u708e\u306e\u767a\u75c7\u3001\u6709\u5bb3\u4e8b\u8c61\u306e\u30d1\u30bf\u30fc\u30f3\u3002<\/p>\n

\u3010Results\u3011
\n\u60a3\u8005\uff08n=433\uff09\u306f5\u65e5\u9593\uff08n=215\uff09\u307e\u305f\u306f10\u65e5\u9593\uff08n=218\uff09\u306e\u30ec\u30b8\u30e1\u30f3\u306b\u30e9\u30f3\u30c0\u30e0\u306b\u5272\u308a\u5f53\u3066\u3089\u308c\u305f\u3002\u30d7\u30ed\u30c8\u30b3\u30eb\u3054\u3068\u306e\u6bcd\u96c6\u56e3\u306e\u81e8\u5e8a\u7684\u6cbb\u7652\u306f\u30015\u65e5\u9593\u306e\u30b0\u30eb\u30fc\u30d7\u306789.6\uff05\uff08n=181\/202\uff09\u300110\u65e5\u9593\u306e\u30b0\u30eb\u30fc\u30d7\u306793.3%\uff08n=182\/195\uff09\u3060\u3063\u305f\uff0895%\u4fe1\u983c\u533a\u9593-9.7\uff5e2.2\uff09\u3002
\n\u7d30\u83cc\u5b66\u7684\u6839\u7d76\u306f\u30015\u65e5\u9593\u306e\u30b0\u30eb\u30fc\u30d7\u306780.4\uff05\uff08n=156\/194\uff09\u300110\u65e5\u9593\u306e\u30b0\u30eb\u30fc\u30d7\u306790.7%\uff08n=165\/182\uff09\u3060\u3063\u305f\u30025\u65e5\u306810\u65e5\u306e\u30b0\u30eb\u30fc\u30d7\u3067\u3001\u305d\u308c\u305e\u308c8\u4eba\u30687\u4eba\u306e\u60a3\u8005\u304c\u518d\u767a\u3057\u30016\u4eba\u306813\u4eba\u306e\u60a3\u8005\u304c\u5408\u4f75\u75c7\u3092\u767a\u75c7\u3057\u30016\u4eba\u306813\u4eba\u306e\u60a3\u8005\u304c\u65b0\u305f\u306a\u6241\u6843\u708e\u3092\u767a\u75c7\u3057\u305f\u3002\u75c7\u72b6\u304c\u7de9\u548c\u3055\u308c\u308b\u307e\u3067\u306e\u6642\u9593\u306f5\u65e5\u9593\u306e\u30b0\u30eb\u30fc\u30d7\u3067\u77ed\u304b\u3063\u305f\u3002\u6709\u5bb3\u4e8b\u8c61\u306f\u4e3b\u306b\u4e0b\u75e2\u3001\u60aa\u5fc3\u3001\u304a\u3088\u3073\u5916\u9670\u81a3\u969c\u5bb3\u3060\u3063\u305f\u300210\u65e5\u9593\u306e\u30b0\u30eb\u30fc\u30d7\u3067\u306f\u767a\u751f\u7387\u304c\u9ad8\u304f\u3001\u6709\u5bb3\u4e8b\u8c61\u306e\u671f\u9593\u304c\u9577\u304b\u3063
\n\u305f\u3002<\/p>\n

\u3010Discussion\u3011
\nA\u7fa4\u30ec\u30f3\u30b5\u7403\u83cc\u54bd\u982d\u6241\u6843\u708e\u306b\u304a\u3044\u3066\u3001\u30da\u30cb\u30b7\u30ea\u30f3V5\u65e5\u95931\u65e54\u56de\u306e\u6cbb\u7642\u306f\u300110\u65e5\u95931\u65e53\u56de\u306e\u81e8\u5e8a\u7d50\u679c\u306b\u52a3\u3089\u306a\u3044\u4e8b\u304c\u5206\u304b\u3063\u305f\u3002\u7d30\u83cc\u5b66\u7684\u6839\u7d76\u306f5\u65e5\u9593\u306e\u6cbb\u7642\u30b0\u30eb\u30fc\u30d7\u3067\u4f4e\u304b\u3063\u305f\u304c\u3001\u75c7\u72b6\u304c\u89e3\u6d88\u3059\u308b\u307e\u3067\u306e\u6642\u9593\u306f\u77ed\u304b\u3063\u305f\u3002\u30b0\u30eb\u30fc\u30d7\u611f\u306e1\u30f6\u6708\u4ee5\u5185\u306e\u518d\u767a\u6570\u306b\u7d71\u8a08\u7684\u6709\u610f\u5dee\u306f\u307f\u3089\u308c\u306a\u304b\u3063\u305f\u3002\u6700\u5f8c\u306e\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u3067\u306f\u30015\u65e5\u9593\u306e\u6cbb\u7642\u30b0\u30eb\u30fc\u30d7\u3067\u65b0\u305f\u306a\u6241\u6843\u708e\u306e\u767a\u75c7\u3068\u5408\u4f75\u75c7\u306e\u6570\u304c\u5c11\u306a\u304b\u3063\u305f\u3002\u307e\u305f\u30015\u65e5\u9593\u306e\u30b0\u30eb\u30fc\u30d7\u3067\u5831\u544a\u3055\u308c\u305f\u6709\u5bb3\u4e8b\u8c61\u306f\u3088\u308a\u5c11\u306a\u304f\u3001\u6709\u5bb3\u4e8b\u8c61\u304c\u751f\u3058\u3066\u3044\u308b\u671f\u9593\u304c\u3088\u308a\u77ed\u304b\u3063\u305f\u3002
\n\u30da\u30cb\u30b7\u30ea\u30f3V5\u65e5\u95931\u65e54\u56de\u306e\u6cbb\u7642\u306f\u3001\u73fe\u5728\u306e10\u65e5\u9593\u306e\u30ec\u30b8\u30e1\u30f3\u306b\u7f6e\u304d\u63db\u3048\u3089\u308c\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002<\/p>\n

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