• 제목/요약/키워드: oral antiviral agents

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소아청소년 영역에서의 새로운 항미생물제 (New Antimicrobial Agents for Children)

  • 은병욱
    • Pediatric Infection and Vaccine
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    • 제16권1호
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    • pp.6-12
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    • 2009
  • There are relatively few novel antimicrobial agents despite the dramatic increase in antimicrobial resistance and multiple drug resistance of clinical isolates worldwide. Vancomycin is still the most widely used antibiotic for treating resistant Gram-positive coccal infections in children, especially for methicillin-resistant Staphylococcus aureus. For children with Gram-positive coccal infections where vancomycin is not effective or older therapeutic agents cannot be tolerated, linezolid, quinupristin-dalfopristin or daptomycin may be useful in the appropriate clinical setting. For Gram-negative bacterial infections, new carbapenems await clinical application. Tebipenem pivoxil is a novel oral carbapenem undergoing clinical trials for acute otitis media in pediatric patients. Antiviral drug development is now progressing at the pace of antibiotic development 30 years ago. Newer antiviral agents used for the treatment of herpes viruses and hepatitis C virus infections in children are included in this review.

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Herpes Zoster Accompanying Odontogenic Inflammation: A Case Report with Literature Review

  • Lee, Soyeon;Kim, Minsik;Huh, Jong-Ki;Kim, Jae-Young
    • Journal of Oral Medicine and Pain
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    • 제46권1호
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    • pp.9-13
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    • 2021
  • Herpes zoster is caused by reactivation and multiplication of a latent varicella-zoster virus infection. Reactivation can frequently occur in older adults and immunosuppressed individuals. It is hypothesized that this is related to an aging society and a corresponding increase in the number of people with underlying chronic diseases, such as cancer and diabetes, that lower immunity. Clinically, the patient complains of pain, and a vesicular rash presents on one side of the face up to the midline in the dermatomes associated with the affected ganglion. Herpes zoster of the oral mucosa is rare. When oral lesions do occur, they are most often concurrent with pathognomonic unilateral linear vesicular skin lesions, facilitating both clinical diagnosis and management of the condition. Cases limited to the oral mucous membrane alone are most unusual. Treatment includes antiviral agents and analgesics for pain control. Antivirals should be administered within 72 hours of onset. Early diagnosis and treatment are important to avoid complications, such as postherpetic neuralgia. The present case report describes the adequate management of a patient diagnosed with shingles which affected the right side of the face and oral cavity. In addition, a literature review is presented.

국내 만성 B형 간염 환자의 경구용 항바이러스제 사용 현황 분석 (Analysis of Drug Utilization in Patients with Chronic Hepatitis B)

  • 이유정;배성진;제남경
    • 한국임상약학회지
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    • 제26권3호
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    • pp.220-229
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    • 2016
  • Background: The treatment goal for patients with chronic hepatitis B infection is to prevent progression of the disease to cirrhosis and hepatocellular carcinoma. Current therapies include standard and pegylated interferon-alfa and nucleoside/nucleotide analogues: lamivudine, adefovir, entecavir, telbivudine, clevudine, and tenofovir. This study aims to analyze changes in the prescribing patterns of chronic hepatitis B (CHB) medications in South Korea between 2013 and 2014. Methods: A cross-sectional study was conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 and 2014. Patients with CHB were identified with Korean Standard Classification of Diseases code-6 (B18.0 and B18.1) and those who were maintaining active prescriptions with CHB medications covering the index date (December $1^{st}$, each year) were included. The utilization of antiviral therapy was investigated during 2013 and 2014. Results: A total of 4,204 and 4,552 patients in 2013 and 2014 respectively, were included in the analysis. The proportion of male patients was two of third and the patients 41-60 years old accounted for 60% of all analyzed patients. The most utilized drug was entecavir (55.1% in 2013 and 44.8% in 2014) and the second most utilized drug was tenofovir in both years (18.8% in 2013 and 29.0% in 2014). The percentage of combination therapy was 13.6% and 13.1% in 2013 and 2014, respectively. The proportion of tenofovir prescriptions was increased in 2014 compared with 2013. Conclusion: With the development of new drugs and the changes in clinical practice guidelines, the prescription pattern of the antiviral agents for patients with CHB has changed. The rate of utilization of tenofovir has increased.

촉규근 추출물에 의한 항인플루엔자 효능 (Anti-influenza properties of herbal extract of Althaea rosea in mice)

  • 김면수;차투랑가 기라마게;김홍익;이종수;김철중
    • 대한수의학회지
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    • 제58권3호
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    • pp.153-158
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    • 2018
  • Althaea rosea has been used in traditional Chinese medicine to treat numerous diseases, but no studies have investigated its anti-influenza properties to date. In this study, we investigated the anti-influenza effects of Althaea rosea. BALB/c mice orally pretreated with Althaea rosea ($200{\mu}L$, 0.1 mg/mL concentration in phosphate-buffered saline) and followed by infection of influenza A virus nasally showed higher survivability and lower lung virus titer against divergent subtypes of influenza A virus infection. We also found that oral administration of Althaea rosea elicited antiviral innate immune responses in serum, bronchoalveolar lavage fluid, small intestinal fluid, and the lungs. Taken together, these findings suggest that aqueous extracts of Althaea rosea are a potential candidate for use as an anti-influenza drug.

마우스에서 울금 에탄올 추출물의 단회 경구투여 독성에 관한 연구 (Acute Oral Toxicity Study of Ethanol Extract of Curcuma longa L. in Mice)

  • 김수환;이형선
    • 생명과학회지
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    • 제24권10호
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    • pp.1132-1136
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    • 2014
  • 울금(Curcuma longa L., turmeric)은 생강과(Zingiberaceae)에 속하는 다년생 초본 식물로 전통적으로 한약재, 향신료 및 식용으로 사용되어 왔다. 강력한 항산화 작용, 울금 에탄올 추출물의 항산화 활성, 항돌연변이성, 항염증, 항암성 및 항균성 효과 등이 보고되고 있다. 그러나 울금에 대한 생리활성 연구는 이미 많이 이루어져 있는 반면 울금에 대한 독성평가는 이루어지지 않았다. 본 연구는 울금 에탄올 추출물에 대한 안정성을 확보하기 위하여 단회경구투여 독성시험을 BALB/c 마우스를 이용하여 실시하였다. 울금 에탄올 추출물은 0, 20, 200, 2,000 mg/kg 농도로 경구 투여하였으며, 14일간 관찰 후 희생시켰다. 울금 에탄올 추출물 투여 후 운동성, 비정상적 임상증상, 부검 소견상, 체중의 유의적인 변화는 관찰되지 않았다. 혈액 생화학적 측정과 다양한 장기의 무게에서도 유의적인 변화를 관찰할 수 없었다. 이들 결과로 미루어볼 때 울금 에탄올 추출물의 단회 투여에 따른 치사량은 2,000 mg/kg 이상을 상회할 것으로 추정되며 급성독성에 어떠한 유해성이 없다는 것을 의미한다.

소아의 B형 만성 활동성 간염에서 저용량 ${\alpha}$-Interferon과 Thymodulin의 병용 치료 효과 (Combined Therapy of Alfa-Interferon and Thymodulin on Children with Chronic Active Hepatitis B)

  • 최병호;고철우
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제1권1호
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    • pp.79-89
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    • 1998
  • 목 적: 만성 B형 간염 환자의 치료에 많은 항바이러스제와 면역조절 물질이 시도되었지만 현재까지는 ${\alpha}$-interferon만이 일정한 효과가 있는 것으로 보고되고 있다. 또 면역조절제 중에는 현재thymodulin 등의 면역증강 물질이 시도되어지고 있다. 저자들은 interferon 치료시 thymodulin을 병용하면 소아의 B형 만성 활동성 간염에 interferon 단독 치료보다 효과가 있는지를 조사해 보았다. 대상 및 방법: 1990년 3월부터 1996년 2월까지 경북대학교병원 소아과에 입원하였던 환아 중 6개월 이상 HBsAg과 HBeAg 및 HBV DNA가 양성(1+~4+)이고, 혈청 AST와 ALT치가 상승되어 있으며 간조직 검사상 만성 활동성 간염으로 확진된 환아 23명($9.8{\pm}2.8$세)을 대상으로 recombinant ${\alpha}$-interferon 300 MU($280\;MU/m^2{\pm}68$; 범위: $189{\sim}448\;MU/m^2$)를 주 3회씩 6개월간 피하 주사하였다. 그 중 10명에게는 thymodulin 60 mg을 매일 복용시켰고 13명은 ${\alpha}$-interferon만 투여하였으며 치료 종료 후 최소 12개월 이상 추적 검사를 하였다. 양군간의 모든 변수에서 통계학적 유의차는 없었다. 결 과: 1) 23명 전예에서 interferon 치료 중에 AST, ALT 및 HBV DNA의 감소가 있었고 12개월째 추적 검사상 9명(39%)에서 평균 3.1개월째에 HBeAg과 anti-HBe의 혈청전환 및 HBV DNA의 음전이 생겼으며 18개월째 추적검사에서는 이 중 2명에서 ${\alpha}$-interferon 중단 후 8개월과 9개월에 HBeAg이 다시 나타났고 또 다른 2명에서 추가로 혈청전환이 생겨서 전체적으로는 23명의 환아 중 11명(48%)에서 혈청전환이 생겼고 재발한 2명을 빼면 최종 성적은 9명(39%)이 된다. 2) 수직 감염이 있는 7례 중 2례(29%)에서 혈청 전환이 생긴 반면 수직 감염이 없는 12례 중 6례(50%)에서 혈청전환이 생겨 수직 감염 유무는 혈청전환과의 상관 관계가 밀접하다고 생각한다. 3) ${\alpha}$-interferon 치료 전의 ALT치가 정상치의 2배 이하인 경우 8례 중 3례(38%)에서 혈청전환이 있었는데 비해 2배 이상이었던 경우는 15예 중 8례(53%)에서 혈청전환이 있어서 ${\alpha}$-interferon 치료전의 높은 ALT치가 좋은 치료 효과를 예측하는데 도움이 될 수 있을 것으로 생각한다. 4) ${\alpha}$-interferon 치료 전의 HBV DNA가 3+ 이상이었던 경우는 12례 중 5례(42%)에서 혈청전환이 있었는데 비해 1+ 이었던 경우는 11례 중 6례(55%)에서 혈청전환이 있어서 ${\alpha}$-interferon 치료전의 낮은 HBV DNA가 좋은 치료 효과를 예측하는데 도움이 될 수 있을 것으로 생각한다. 5) B형 만성 활동성 간염 환아 23례 중 10례에게 thymodulin을 병용하여 투여하였으나 10례 중 5례(50%)에서 혈청전환이 있었으며 이는 대조군인 ${\alpha}$-interferon 단독 치료 시의 13례 중 6례(46%)와 비교할 때 통계적인 의의를 찾을 수 없었다. 결 론: 면역조절 물질인 thymodulin의 투여로써 숙주 면역계의 기능을 증강시켜 바이러스의 제거를 촉진하고자 소아의 B형 만성 활동성 간염에 ${\alpha}$-interferon 치료시 thymodulin을 병용하여 치료하였으나 ${\alpha}$-interferon 단독 치료보다 더 효과가 있다고 볼 수는 없었으며 향후 더 많은 환아를 대상으로 한 interferon과 다른 종류의 항바이러스제 및 면역조절제 등과의 병용 치료 연구가 더 좋은 결과를 얻기 위해 필요할 것으로 생각한다.

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구창의 문헌연구 (A literal study on the Gu-Chang)

  • 정한솔;박종훈;육상원;이광규
    • 동의생리병리학회지
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    • 제16권1호
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    • pp.32-44
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    • 2002
  • Gu-Chang is a disorder characterized by recurring ulcers confined to the oral mucosa. Despite much clinical and research attention, the causes remain poorly understood. In this paper, we will compare Gu-Chang with Recurrent Aphthous Stomatitis(RAS) in order to know what is the similiarity between Gu-Chang and RAS. So we will arrange various oriental and western medical literatures which are important. As a result of arrangement of the causes, symptoms and therapys of Gu-Chang, we can conclude through the studies as follows. 1. The etiologies of Gu-chang are following. In the Sthenia syndrome, there are evil heat of external factor, heat of heart and spleen, insomnia, heat of upper warmer, stress and diet, heat of lung and heart, excessive heat of upper warmer, inappropriate food intake, heat conveyance of organ, heat of stomach merdian, moistured heat of spleen and stomach and stasis of liver energy. In the Asthenia syndrome, there are deficiency of stomach energy, deficiency of upper warmer leading to heat, deficiency of middle warmer leading to cold, deficiency of lower warmer leading to heat, deficiency of middle energy, deficiency of blood, decreased fire and deficiency of soil, yin fire of lower warmer, deficiency of heart yin, deficiency of spleen yin and deficiency of qi and blood. 2. In western medicine the causes of RAS is presumed as local, microbial, systemic, nutritional, genetic, immunologic factors. 3. Once Gu-chang is compared with RAS, in the deficiency of yin leading to hyperactivity of fire, deficiency of yin leading to floating of fire and stasis of liver energy, recurring of Gu-chang is similar to RAS. Although recurring of Gu-chang due to tripple warmer of excessive fire has no recurrance, since there are the degree of Pain, site of lesion, dysphagia etc, it is similar to major RAS. It is may be believed that Sthenia Gu-chang is similar to major RAS, shape of recurring, site of lesion, degrree of Pain and white color of Asthenia Gu-chang are similar to minor RAS, but there is no similarity concerning herpes RAS in the literatures that describe the symptoms. 4. Generally, the treatment of Gu-chang is divided into Asthenia and Sthenia Syndrome. The method of cure to Sthenia syndrome is heat cleaning and purge fire, Asthenia syndrome is nourish yin to lower and adverse rising energy and strength the middle warmer and benefit vital energy. 5. Following is the medication for Sthenia syndrome. Heat of heart and spleen is Do Jok San, Yang Gyek San, Juk Yup Suk Go Tang, evil heat of external factor is Yang Gyek San Ga Gam, Stasis of liver energy is Chong Wi Fae Dok Yum, moistured heat of spleen and stomach is Chong Gi Sam Syep Tang. The medication for Asthenia Syndrome is following. Deficiency of upper warmer leading to heat is Bo Jung Ik Gi Tang, deficiency of middle warmer leading to cold is Bu Ja Lee Jung Tang, deficiency of lower warmer leading to heat is Yuk Mi Ji Hwang Tang, deficiency of yin leading to hyperactivity of fire is Ji Baek Ji Hwang Hwan, deficiency of yin leading to floating of fire is Lee Jung Tang Ga Bu Ja Medicine for external use were Yang Suk San, Boo Wyen San, Rok Po San, Yoo Hwa San ate. 6. In western medicine, there is no specific treatment for RAS, and management strategies depend on dinical presentation and symptoms and includes antibiotics, oral rinses, glucocorticoids, immunomodulatory drugs, vitamines, analgesics, laser and antiviral agents.