経験的治療
WordNet
- (medicine) the act of caring for someone (as by medication or remedial training etc.); "the quarterback is undergoing treatment for a knee injury"; "he tried every treatment the doctors suggested"; "heat therapy gave the best relief"
- relying on medical quackery; "empiric treatment" (同)empirical
PrepTutorEJDIC
- (病気の)治療,療法 / =psychotherapy
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出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/07/07 14:40:22」(JST)
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Empiric therapy is a medical term referring to the initiation of treatment prior to determination of a firm diagnosis. It may be thought of as taking the initiative against an anticipated and likely cause of infectious disease. It is most often used when antibiotics are given to a person before the specific bacterium causing an infection is known. Examples of this include antibiotics given for pneumonia, urinary tract infections, and suspected bacterial meningitis in newborns aged 0 to 6 months.
Empiric antibiotics are typically broad-spectrum, in that they treat both Gram-positive and Gram-negative bacteria. When more information is known (as from a blood culture), treatment may be changed to a narrow-spectrum antibiotic which more specifically targets the bacterium known to be causing disease.
The advantage of indicating antibiotics empirically exists where a causative pathogen is likely albeit unknown and where diagnostic tests will not be influential to treatment. In this case, there may be little if any perceived benefit of using what may be costly and inconclusive tests that will only delay treatment of the same antibiotics.
The empirical use of broad-spectrum antibiotics increases, by selection, the prevalence of bacteria resistant to several antibiotics.
See also
- Broad-spectrum antibiotic
UpToDate Contents
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English Journal
- Rational Helicobacter pylori Therapy: Evidence-Based Medicine Rather Than Medicine-Based Evidence.
- Graham DY1, Lee YC2, Wu MS2.Author information 1Department of Medicine, Michael E. DeBakey VA Medical Center, and Baylor College of Medicine, Houston, Texas. Electronic address: dgraham@bcm.edu.2Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.AbstractData are available such that choice of Helicobacter pylori therapy for an individual patient can be reliably predicted. Here, treatment success is defined as a cure rate of 90% or greater. Treatment outcome in a population or a patient can be calculated based on the effectiveness of a regimen for infections with susceptible and with resistant strains coupled with the knowledge of the prevalence of resistance (ie, based on formal measurement, clinical experience, or both). We provide the formula for predicting outcome and we illustrate the calculations. Because clarithromycin-containing triple therapy and 10-day sequential therapy are now only effective in special populations, they are considered obsolete; neither should continue to be used as empiric therapies (ie, 7- and 14-day triple therapies fail when clarithromycin resistance exceeds 5% and 15%, respectively, and 10-day sequential therapy fails when metronidazole resistance exceeds 20%). Therapy should be individualized based on prior history and whether the patient is in a high-risk group for resistance. The preferred choices for Western countries are 14-day concomitant therapy, 14-day bismuth quadruple therapy, and 14-day hybrid sequential-concomitant therapy. We also provide details regarding the successful use of fluoroquinolone-, rifabutin-, and furazolidone-containing therapies. Finally, we provide recommendations for the efficient development (ie, identification and optimization) of new regimens, as well as how to prevent or minimize failures. The trial-and-error approach for identifying and testing regimens frequently resulted in poor treatment success. The described approach allows outcome to be predicted and should simplify treatment and drug development.
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.Clin Gastroenterol Hepatol.2014 Feb;12(2):177-186.e3. doi: 10.1016/j.cgh.2013.05.028. Epub 2013 Jun 8.
- Data are available such that choice of Helicobacter pylori therapy for an individual patient can be reliably predicted. Here, treatment success is defined as a cure rate of 90% or greater. Treatment outcome in a population or a patient can be calculated based on the effectiveness of a regimen for in
- PMID 23751282
- Comparative analysis of empiric antimicrobial treatments for skin and soft tissue infections in newly hospitalized patients.
- Yazdani C, Hanna N.Author information Department of Pharmacy, John C. Lincoln Health Network, North Mountain Hospital, Phoenix, AZ, USA.AbstractPurpose: Intravenous vancomycin is the standard empiric treatment for complicated skin and soft tissue infections (SSTIs) due to its coverage against methicillin-resistant Staphylococcus aureus (MRSA). The objective of this study was to compare the hospital length of stay (LOS) between vancomycin-treated patients and patients receiving newer anti-MRSA agents. The study also aimed to identify factors associated with therapy change in patients receiving vancomycin on admission. Methods: Electronic medical records were used to conduct this retrospective cohort study. The LOS was compared among 5 groups of adult patients with admission diagnoses for SSTI who were initiated on linezolid, daptomycin, ceftaroline, tigecycline, or vancomycin. Survival analysis was used to identify factors associated with therapy change from vancomycin to another study medication. Results: Vancomycin was prescribed in 1046 (92%) admissions. Although none of the between-group differences in LOS reached statistical significance, there was a trend toward shorter LOS in vancomycin-treated patients compared to linezolid-treated patients (P = .059). Coagulopathy was independently associated with increased likelihood of therapy change from vancomycin (hazard ratio = 4.71; P <.001). Conclusions: In the treatment of SSTI, newer agents result in LOS comparable to vancomycin. In patients initiated on vancomycin, therapy change was associated with longer LOS. Coagulopathy was independently associated with increased probability of therapy change.
- Journal of pharmacy practice.J Pharm Pract.2014 Feb;27(1):53-60. doi: 10.1177/0897190013504955. Epub 2013 Sep 27.
- Purpose: Intravenous vancomycin is the standard empiric treatment for complicated skin and soft tissue infections (SSTIs) due to its coverage against methicillin-resistant Staphylococcus aureus (MRSA). The objective of this study was to compare the hospital length of stay (LOS) between vancomycin-tr
- PMID 24076599
- Suspected piperacillin-tazobactam induced nephrotoxicity in the pediatric oncology population.
- Pratt JA, Stricherz MK, Verghese PS, Burke MJ.Author information Department of Pediatrics, University of Minnesota Amplatz Children's Hospital, Minneapolis, Minnesota.AbstractNeutropenic fever is a common complication of myelosuppressive therapy in pediatric oncology patients. Piperacillin-tazobactam (PIP/TAZO) is a broad spectrum antibiotic used for empiric treatment of neutropenic fever. We describe four cases of suspected PIP/TAZO induced nephrotoxicity occurring in children with pediatric malignancies admitted to the hospital and treated for fever ± neutropenia. All patients exhibited acute renal injury shortly after PIP/TAZO administration with one of these cases having biopsy evidence of acute interstitial nephritis. These findings are suggestive of PIP/TAZO induced nephrotoxicity in pediatric oncology patients with fever ± neutropenia and that PIP/TAZO should be used judiciously in this population. Pediatr Blood Cancer 2014;61:366-368. © 2013 Wiley Periodicals, Inc.
- Pediatric blood & cancer.Pediatr Blood Cancer.2014 Feb;61(2):366-8. doi: 10.1002/pbc.24720. Epub 2013 Aug 30.
- Neutropenic fever is a common complication of myelosuppressive therapy in pediatric oncology patients. Piperacillin-tazobactam (PIP/TAZO) is a broad spectrum antibiotic used for empiric treatment of neutropenic fever. We describe four cases of suspected PIP/TAZO induced nephrotoxicity occurring in c
- PMID 24038944
Japanese Journal
- 血液疾患,悪性腫瘍(Febrile Neutropeniaを含む) (特集 小児感染症2011 : 今どうなっているの?小児の感染症) -- (特殊な病態下における小児感染症の管理,最近の考え方は?)
- 犬猫の各種感染症における原因菌とアンチバイオグラム
- 嶋田 恵理子,宮本 忠,鳩谷 晋吾
- 日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 64(10), 810-815, 2011-10-20
- NAID 10029836311
Related Links
- Empiric Therapy (起炎菌不明時の経験的投与法 ) 1 st choice :合成ペニシリン( PIP など) あるいは第 3 世代セフェム ↓ [理由]抗菌スペクトルが広い。副作用が少ない。 [欠点]合成ペニシリンはグラム陰性桿菌に弱い
- empiric treatment. See treatment. treatment [trēt´ment] 1. the management and care of a patient; see also care. 2. the combating of a disease or disorder; called also therapy. Schematic of the treatment planning process using ...
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- empiric treatment, empiric therapy
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- エンピリック治療
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- care、cure、curing、practice、psychotherapy、regimen、remediation、remedy、therapeutic、treat、treatment、treatment protocol
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- 関
- a priori、empirical、empirically、experimental