급성 방광 염 치료 지침 (약물 요법 비교 평가 와 건강 기능 식품 비교 평가) > 복약 지도

급성 방광 염 치료 지침 (약물 요법 비교 평가 와 건강 기능 식품 비교 평가)

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급성 방광 염 치료 지침 
 
(약물 요법 비교 평가 와 
 
건강 기능 식품 비교 평가)</TD></TR>
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여인들의 급성 방광염에 대하여
 
미국과 유럽 감염 학회가 발표한 1차 선택 약은 아래 표와 같다
  
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급성 방광 염 치료 ) </TD></TR>
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1</TD>
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Nitrofurantoin</TD>
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1일 2회 1회 100mg</TD>
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5일간 </TD></TR>
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2</TD>
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Tmp/Smx</TD>
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1일 2회 1회 80mg/400mg</TD>
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3일간 </TD></TR>
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3</TD>
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Fosfomycin</TD>
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1일 1회 1회 3gm</TD>
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1일만</TD></TR>
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(Tmp/Smx : Trimethoprim + Sulfamehoxazole)</TD></TR></TBODY></TABLE>
            
 
이유인즉 이들 항균제는 아직도 93%의 치료 율을 나타낼 뿐 아니라
 
내성을 가장 적게 일으키고 있기 때문이다
 
이는 미국과 유럽이 공동으로 주관하는 
 
국제 감염 증 치료 지침 제정 위원회가 2011년 3월에 발표한 내용이다
 
 
<IMG src="/_dimg/1%20방광염.bmp">
 
[그림] 급성 요로감염은 자기 항문에 있는 대장균이 요로를 침입하여 방광에서 일으키는 병이다 여인의 요로는 매우 짧으므로 여인에게 
   주로 방광 속에서 염증을 일으킨다 (성병이 아니다)</TD></TR>
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Quinolone계는 사용 말라</TD></TR>
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지금까지 많이 사용 되어온
 
Ciprofloxacin  
 
Ofloxacin 
 
Levofloxacin 같은 퀴놀론계 항균제는 
 
급성 방광염에 사용치 않도록 강력히 권장하고 있다
 
 
왜냐하면 이들 항균제는
 
아직은 치료 율이 90%이상이지만
 
내성이 증가하고 있어
 
급성 방광 염 보다 더 중대한 감염 증을 
 
치료하는데 사용해야 하기 때문이다</TD></TR>
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베타락탐계도 사용 말라</TD></TR>
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베타 락탐계 항생제인 
 
Amoxicillin과 
 
Cefalexin은
 
이미 내성을 많이 일으켰으므로 사용하지 말라고 했다
 
 
그러나
 
 Amoxicillin/Clauvulanae와 
 
 Cefaclor 
 Cefdinir 
 Cefpodoxine은 
 
아직은 잘 듣는 항생제들이지만
 
 보다 더 중대한 감염 증 치료에 사용해야 하며
 
 쉽게 치료할 수 있는 급성 방광 염에는  사용하지 안 해야 한다고 했다
 
 
 
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[그림] 페니실린 계와 세파계는 동일한  Lactam환을 지니며 내성을 일으킨
          균은 화살표 선을 파괴시켜 항균력을 없앤다</TD></TR>
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25%-40%는 저절로 낫는 감염 증</TD></TR>
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급성 방광염은 여인들에게 가장 많은 질환이다 
 자기 항문 주위에 오염되어 있는 대장균이
 
 짧은 요로를 통해 들어가서 방광에서 일으키는 감염 증이다 
 
배뇨 시 통증과 긴급 배뇨 증상을 나타낸다 
 
20-40%의 경우는 항균요법을 하지 않더라도 저절로 낫는 병이다
 
 
해서 많은 여인들은 오줌 소태에 듣는다고 광고하는 
 
 기능성 건강 식품을 사용하면서 낫는 줄로 생각한다
 
 
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[그림] 방광에는 많은 신경이 연결되어 있으며 매우 신경이 예민하다 
  때문에 요로감염증에 걸리면 자주 배뇨하며, 긴급 뇨 현상을 나타낸다.</TD></TR>
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Cranberry Juice 의 약효</TD></TR>
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15 종의 기능성 건강 식품이  급성 요로감염에 사용되고 있다
 
 
 
그러나 아래 표에서 보는 바와 같이 
 
어느 것 하나도 급성 요로 감염 증 치료를 위해 
 
자료가 불출분하므로 권장할 수 없는 것으로 나타나있다
 
 
다만 Cranberry 주스는 
 
대장균이 현재 일으키고 있는 요로감염증을 치료는 못하지만 
 
 
항균 요법을 치료하고 난 후 재발하는 것은 막아줄 수 있다
 
새로운 대장균이 요로를 타고 들어가  방광 벽 부착하는 것을 막아줄 수 있다

 
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 [그림] Cranberry 
 
 
 
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기능성 건강 식품 비교 평가 </TD></TR>
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 </TD>
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안전에
버금</TD>
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안전
할수도</TD>
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자료
불충분</TD>
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위험
할수도</TD>
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위험에
버금</TD>
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위험함</TD></TR>
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유효함</TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD>
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유효에
버금</TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD>
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유효
할수도</TD>
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크랜베리</TD>
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 </TD>
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 </TD>
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자료
불충분</TD>
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아스파라거스
Blueberry
Echinacea
마늘
유산균
요구르트</TD>
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Bifido 균
Glodenseal
Lovge
Parsely
Stingin Nettle</TD>
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Goldenrod
Java tea </TD>
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Uva ursi
(기형성
 발암성)
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 </TD>
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무효
할수도</TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD></TR>
<TR>
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무효에
버금</TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD>
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 </TD></TR>
<TR style="mso-yfti-irow: 8; mso-yfti-lastrow: yes">
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무효함</TD>
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 </TD>
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 </TD>
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 63.75pt; PADDING-RIGHT: 5.4pt; BACKGROUND: red; BORDER-TOP: #ffffff; BORDER-RIGHT: black 1pt solid" width=85>
 </TD>
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 63.8pt; PADDING-RIGHT: 5.4pt; BACKGROUND: red; BORDER-TOP: #ffffff; BORDER-RIGHT: black 1pt solid" width=85>
 </TD>
<TD style="BORDER-BOTTOM: black 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 63.8pt; PADDING-RIGHT: 5.4pt; BACKGROUND: red; BORDER-TOP: #ffffff; BORDER-RIGHT: black 1pt solid" width=85>
 </TD>
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 </TD></TR></TBODY></TABLE>
 
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<TBODY>
<TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes">
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녹색</TD>
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권장할 수 있다</TD></TR>
<TR>
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노랑색 </TD>
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권장 하지 않는다</TD></TR>
<TR style="mso-yfti-irow: 2; mso-yfti-lastrow: yes">
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빨간 색</TD>
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적극 금지 시킨다</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>
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<TBODY>
<TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes; mso-yfti-lastrow: yes">
<TD class=tbl2-ref1>
근거</TD>
<TD class=tbl2-ref2>
1.   Guidelines: Intenational Clinical Priactice Guidelines for the
    Tretmenty of acute Uncompicated Cystitis and Pyelonephriti s in women
    By the Infectious Diseasde Sciety of Ameircan and the Euroean
    Society for Microbioogy and Infedctious dieases  Marcch 2011
2 Pharmacist's Letter Online Continuing Education ;Natural Medicines in the Clinical Management of Urinary Tract Infections  Volume 10, No. 110</TD></TR></TBODY></TABLE>
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