골반염 치료의 최신 지견
Update on the management of pelvic inflammatory disease
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골반염은 미생물 감염에 의해 자궁경부내구 상부의 생식기에 염증이 발생한 질환으로 난임, 자궁외 임신, 만성 골반통 등의 후유증을 남길 수 있어 골반염의 치료 시 적절한 항생제의 선택은 매우 중요하다. 여러 국가나 국제단체에서 골반염 치료를 위한 여러 권고안을 제시해 왔고, 대부분의 권고안에서 quinolone을 주 치료 항생제로 선택하고 있다. 그러나 최근 quinolone에 저항성을 보이는 임균(N. gonorrhea)이 증가하고 있으며 골반염의 원인으로 새로운 세균들이 출현하고 있으므로 현재 사용되고 있는 골반염 치료 권고안에 대한 재고가 필요하다. 따라서 본 종설에서는 골반염에 대한 최근의 문헌을 고찰하여 최근 골반염 원인균의 변화와 치료 항생제 효과에 대한 연구결과들을 살펴보고 어떤 항생제를 선택하는 것이 효과적인지에 대해 알아보았다.
Abstract
Pelvic inflammatory disease (PID), the infection and inflammation of a woman’s upper genital tract, is a frequent cause of infertility, ectopic pregnancy, and chronic pelvic pain among women of childbearing age. The management of PID has been largely based on the protocols issued by national or international institution. These guidelines recommended a broad-spectrum antibiotherapy in which quinolones continue to hold a key place. Yet, several significant facts such as the increase of quinolone-resistant gonococci and the emergence of ‘new’ pathogens have recently led us to reconsider the paradigms of the management of PID. This article reviewed lately published literatures on new bacteriological finding and recent antibiotics trials to delinate optimal regimen in managing PID.
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