耳鼻咽喉科における抗菌薬の正しい使い方

―耳・鼻疾患―

抄録

Antimicrobial therapy for acute infections of otorhinolaryngological conditions, especially ear and nose diseases, were described based on the “Clinical Practice Guidelines for the Diagnosis and Management of Acute Otitis Media (AOM) in Children in Japan, 2013 update” and the “Clinical Practice Guidelines for Acute Rhinosinusitis in Children and Adults in Japan, 2010 Additional Edition.” The method to treat these infections by selecting and administering antimicrobial agents in actual practice will also be explained at the same time. In actual treatment, it is important to first determine the pathogenic bacteria and then to select and administer appropriate antibiotics according to the results. The two major causal agents of these infectious diseases are Streptococcus pneumoniae and Haemophilus influenzae. If the infectious bacteria are unknown, then antimicrobial therapy against S. pneumoniae should be administered, as it is strongly pathogenic. Although judging the therapeutic effect is important, there is a need for using a scoring system to decide whether to continue antimicrobial therapy, change the antimicrobial agent, or stop antibiotic administration by judging the effectiveness of the therapy (improvement, healing). In the treatment of acute otitis media at our hospital, good treatment results have been obtained by applying such a policy for treatment.