항균제의 적정 약물요법

강문원 大韓臨床藥理學會 1994 臨床藥理學會誌 Vol.2 No.2

Enterococcus Faecalis에 의한 Clostridium Perfringens의 증식 억제 효과

신완식,유진홍,강문원 대한감염학회 1992 감염 Vol.24 No.2

It has known that some strains of Enterococcus faecalis inhibit some strains of enterococci and group D streptococcal species by production of enterocin. We found that Clostridium perfringens did not grow in our previous report of 'In vivo efficacy of cefotetan and cefoxitin in an intraabdominal abscess mode in the mouse'. So we designed our experiments in vivo and in vitro to find out what bacteria inhibit the growth of C. perfringens. The results were as follows; 1) C. perfringens from the intraabdominal and the subcutaneous abscess model using 5 bacterial isolates and autoclaved cecal content were not found. In vitro studies with various combination of organisms, C. perfringens did not grow in the groups of the co-culture with E. faecalis. 2) In vivo models using E. faecalis (??) and C. perfringens (??), we couldn't find any colonies of C. perfringens although we used a more concentration of C. perfringens than E. faecalis. 3) In direct and deferred antogonism test, inhibition zone to C. perfringens by E. faecalis was found, and more concentration of E. faecalis was necessary for inhibition of C. perfringens. 4) The inhibition zone by E. faecalis filtrates using 0.22um filter was also found, but we couldn't see any inhibition when we diluted the E. faecalis filtrates. 5) C. septicum, C. cadaveris, and C. subterminale were inhibited by E. faecalis, whereas C. difficile, and C. sporogenes were not inhibited.

중추신경계의 감염성 질환: 항생제 사용의 실제

강문원 대한신경과학회 2004 대한신경과학회지 Vol.22 No.2

Infections of the central nervous system (CNS) can be rapidly progressive, resulting in death or permanent neurological damage in a short period of time, because of focal immunocompromised milieu with few complements and immunoglobulins in the cerebrospinal fluid. In order to provide effective antimicrobial therapy in a timely manner, all clinicians need to have a basic understanding of the antimicrobial agents and epidemiological data of the disease. It takes time to reveal the causative organisms of the infection. One should start antimicrobial treatment empirically as soon as possible after collecting the specimens from the patient. Many factors influence the choice of antimicrobial agents in the treatment of the infection which include microorganisms, environmental factors, and host factors such as age, sex, site of infection, and the underlying disease of the patient. Especially, in CNS infections, the efficacy of an antimicrobial agent depends upon its ability to penetrate the blood-brain barrier. The antimicrobial agent should also be active in purulent cerebrospinal fluid and demonstrate rapid bactericidal activity against the offending pathogen. The recent emergence of resistant pathogens, (also seen in Korea), has posed a challenge to the antimicrobial therapy. Therefore, the guidelines of antimicrobial therapy should be suitable for these considerations. This article reviews the basic therapeutic principles for the treatment of infections of the CNS and gives recommendations for the treatment of specific infections.

몇가지 질환을 가진 환자에서 Gentamicin의 혈청농도와 약역학

강문원 가톨릭대학 (가톨릭신학대학) 대학원 1987 가톨릭大學醫學部 論文集 Vol.40 No.4

폐렴의 통원치료

姜文元 대한의사협회 1996 대한의사협회지 Vol.39 No.8

국내 항생제 오·남용에 따른 문제점 및 개선방안 : 감염학계의 의견 Opinion of the society of infectious diseases

강문원 대한화학요법학회 1997 대한화학요법학회지 Vol.15 No.2

국내에서 항생제의 생산금액이 드디어 1조원을 넘었다. 생산금액을 기준으로 보면 cephalosporin coside제제, quinolone제제의 순이며, 생산량으로는 penicillin제제가 가장 많고 그 다음을 cephalosporin제제가 차지한다. 단일 품목으로는 amoxicillin이 생산액 및 생산량에서 가장 많은 부분을 차지하지만, 국내에서 분리되는 대부분의 그림음성균은 amoxicillin에 내성을 보이며, 감수성을 보이는 균은 아주 일부에 지나지 않는다. 따라서 amoxicillin을 투여 받은 환자의 대부분은 항생제를 처방하지 않아도 회복될 수 있는 환자일 가능성이 ㅁㅎ으며, 불필요하게 투여 받는 것이 아닌가? 하는 생각도 든다. 조금 오래된 자료이지만 우리나라에서 항생제의 오 · 남용이 64%에 이른다는 보고가 있다. 이러한 항생제의 오 · 남용 문제를 개선시키기 위하여서는 몇 가지 관점으로 나누어 분석해볼 필요가 있다.

호흡기 감염증에 대한 Cefixime의 임상 효과

박성학,박주현,신완식,김관형,한현복,김양리,강문원 대한감염학회 1990 감염 Vol.22 No.3

Clinical efficacy and safety of cefixime, a new oral cephem antibiotics, were evaluated in 30 patients with respiratory tract infection. Cefixime was administered to 30 cases consisting of 4 cases of acute tonsillitis, 16 cases of pneumonia (8/16 have underlying chronic lung disease) and 10 cases of acute exacerbation of chronic lung diseases (3 with bronchiectasis, 2 with bronchial asthma and 5 with chronic obstructive lung diseases), at daily dosis of 200~400㎎ for 5~21 days by oral route. Clinical efficacy was evaluated to be excellent in 11 cases, good in 13 cases, fair in 5 cases and poor in 1 case. Thus cefixime was effcetive in 24 of 30 cases in total with a rate of effectiveness of 80%. Effectiveness of cefixime was 100% (12/12) in acute disease, but 66.7%(12/18) in chronic or complicated disease. 16 microorganisms were isolated from 13 cases. 10 cases were eradicated, 2 cases were persisted and 1 case was superinfected with P. aeruginosa. Adverse resactions were found in 3 cases: 1 with eosinophilia, 1 with anorexia and 1 with eosinophilia and skin rash to whom cefixime was discontinued. In conclusion, cefixime is useful oral drug for the empirical treatment of mild to moderate respiratory tract infection.

내과영역에서의 항생제 선택

강문원 대한화학요법학회 1987 대한화학요법학회지 Vol.5 No.2

감염증환자 또는 감염증이 의심되는 환자를 처음 대했을 때 어떤 항균제를 어떻게 부여할 것이냐? 하는 것은 매우 복잡한 문제이다. 규모가 큰 병원에서도 항균제를 올바르게 사용하는 것이 매우 힘든 일인데, 검사실기능이 약화된, 특히 미생물 계통의 검사기능이 거의 없다시피한 국내 개원가에서는 더욱 복잡한 문제들이라 하겠으며, 오로지 경험에만 의존하는 경향이라 할 수 있겠다. 이와 더불어 이 환자에게 항균제 투여가 꼭 필요하냐?를 결정하는 것도 매우 중요한 일이다.  

심근염과 완전 방실차단 및 췌장염이 합병된 장티푸스 1예

안유배,김양리,유진홍,신완식,강문원 대한감염학회 1993 감염 Vol.25 No.3

The report of completer atrioventricular (AV) block wit myocarditis complicating typhoid fever is a rare occurrence. The patient was a 30-year-old woman and experienced fever, chill and abdominal pain two weeks earlier followed by mental confusion. Typhoid fever was confirmed by islolation of S. typhi in blood and stool. Laboratory examination showed the elevation of cardiac enzymes and serum amylase level. On the fifth hospital day, complete AV block developed transiently and disappeared without any intervention. The patient was treated with dexamethasone and a two-week course of chloramphenicol. We report a case of typhoid fever complicated by complete AV block, myocarditis and pancreatitis.

부산ㆍ후쿠오카 생활시간 비교연구

강문원,김희재 동북아시아문화학회 2008 동북아 문화연구 Vol.1 No.16

This paper try to find desirable time management strategy through the understanding and comparison of time use study in Busan and Fukuoka. For this, we compared and considered average time spent on activities for all persons, average time spent for pariticipant, participation rate, participation rate by time of day in Busan and Fukuoka. After the comparison, characteristics of Busan time-use tendency came out general tendency that due to the spread of 5day work week system, decrease of labor time and increase of free-time, but Fukuoka revealed unexpected result that is increase of labor time and decrease of lesuire time, inversely. And we found out that Busan not only the standardization of meal time and concentration of labor time are more behind but also moving time that including commuting to and from school or work are too much higher than Fukuoka, So we must search for new time management strategy to enhance the citizen's quality of life in Busan.