【連載・第5回】呼吸器内科医のための肺移植の診かた■肺移植後の抗菌化学療法■平間　崇 |

【連載】呼吸器内科医のための肺移植の診かた／A guide to lung transplant for pulmonologists

第5回　←今ここ

第5回　肺移植後の抗菌化学療法

平間　崇^*,**

^*東北大学加齢医学研究所呼吸器外科学分野（〒980-8575宮城県仙台市青葉区星陵町4-1）

^**東北大学病院臓器移植医療部

Antimicrobial management after lung transplantation

Takashi Hirama^*,**

^*Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University

^**Division of Organ Transplantation, Tohoku University Hospital

Keywords：肺移植，感染症，抗菌薬，薬剤相互作用，サイトメガロウイルス，アスペルギルス，緑膿菌，非結核性抗酸菌／lung transplant, infection, antibiotics, drug interaction, cytomegalovirus, Aspergillus, Pseudomonas, non-tuberculous Mycobacteria

呼吸臨床 2022年6巻11号　論文No.e00160
Jpn Open J Respir Med 2022 Vol. 6 No. 11 Article No.e00160

DOI: 10.24557/kokyurinsho.6.e00160

掲載日：2022年11月28日

©️Takashi Hirama. 本論文の複製権，翻訳権，上映権，譲渡権，貸与権，公衆送信権（送信可能化権を含む）は弊社に帰属し，それらの利用ならびに許諾等の管理は弊社が行います。

要旨

　肺移植患者は様々な要因から感染症を発症する。感染症は移植臓器（グラフト）に生じやすく，グラフト機能不全はレシピエントにとって致命的となりえることから，移植医療では予防投与が幅広く行われている。一方，肺移植において，感染症治療のアプローチも様々である。周術期や感染症を発症するリスクが極めて高い状況下では先行治療を行うことも多く，グラフトへの感染では起炎病原体が確定するまでの初期治療も広域かつ複数の抗菌化学療法を使用することもある。また，確定的治療は抗菌薬投与期間もグラフト機能が改善するまで継続するなど，日常診療とは異なる対応も多い。ここでは肺移植に用いられる抗菌化学療法について記載するが，移植施設により抗菌化学療法プロトコールは異なる。そのため，本連載では東北大学病院またはトロント総合病院の使用例を提示しながら解説する。

文献

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