COVID-19 and Marfan/VEDS/LDS: Your Questions Answered
34:35-39:50
Okay, can we have a next slide? Hal, do you want to take this one with the antibiotic clip?
次のスライドは抗菌剤についてです。Dietz先生お願いします。
Sure, um so COVID-19 is caused by infection with a virus. It's, it's called the SARS-Co-v2 virus, so if you hear that name, that's what they were referring to. Viruses do not respond to antibiotics, a class of medications used to kill bacteria, but sometimes when people get a viral infection, they can get a secondary bacterial infection. The virus causes the host body defenses to become weakened and then bacteria take advantage of that weakened state so you can develop a secondary bacterial infection.
COVID-19は、SARS-Co-v2ウイルスによる感染症です。細菌を殺す薬である抗菌剤はウイルスには効果がありません。ですが、ウイルス感染症に罹患した場合、細菌による二次感染を起こすことがあります。ウイルス感染症によって身体の防御機能が下がることで、細菌による感染が起こり、二次的な細菌感染症を発症することがあります。
There is a class of antibiotics now becoming a fairly common class of antibiotics that can be used to treat bacterial infections called fluoroquinolones. Now these drugs are known to impair the quality and strength of connective tissue in the body that can involve tendons of the body. It can involve the muscle connective tissue but prominently can also involve the vascular connective tissue because of that impairment of the quality and strength of connective tissue.
細菌性の感染症の治療に一般的に用いられるフルオロキノロンと呼ばれる種類の抗菌薬があります。フルオロキノロン系の抗菌薬は、靱帯などの結合組織の機能を低下させることが知られています。影響を受けるのは筋肉の結合組織ですが、主に血管の結合組織にも影響が及びます。
It's currently recommended that people with aortic enlargement in general, people with a a risk of aortic dissection in general and people specifically with vascular connective tissue disorders should avoid this class of antibiotics if there is any good alternative.
一般に、代替薬がある場合には、大動脈が拡張している方、大動脈解離のリスクのある方、血管の結合組織疾患の方に対しては、フルオロキノロン系の抗菌薬の使用を避けることが推奨されています。
Certainly if your doctor is telling you that you have a very severe infection that it is a life-threatening bacterial infection and that the only class of antibiotics that will work to get that infection under control is a is the fluoroquinolone antibiotics, then by all means you should take that antibiotic to get the severe bacterial infection under control. But if there are other good choices or if it's a mild infection, then you and your physicians should proceed with caution about using these medications, this particular type of antibiotic.
命に関わるような非常に重篤な細菌性感染症で、効果が期待できるのがフルオロキノロン系の抗菌薬のみの場合には、もちろん使う必要があります。しかし、代わりに使える薬があったり、軽度の感染症である場合には、使用には注意が必要です。
Some of the names of the common fluoroquinolones are included at the bottom of this slide. Um, you'll hear some discussion of a class of medications that people are postulating might be useful for people with COVID-19 infection. (Joe, are we gonna get into that in later slides or yeah we do have that question that comes up in a later slide so if you want to hold on to that, we can, you know) Just to finish the thought, something called chloroquine or hydroxychloroquine that sounds an awful lot like fluoroquinolones. We'll get into that later in the discussion but it's not the same thing. You should not equate the risks associated with fluoroquinolones with comparable risks regarding these other medications that we'll talk about.
このスライドの下に代表的なフルオロキノロン系の抗菌薬を載せてあります。COVID-19に効果のある薬については様々な憶測がありますが、それについては後のスライドで取り上げます。クロロキンやヒドロキシクロロキンのように、フルオロキノロンと名前が似た薬もありますが、リスクが異なりますので、これについても後で説明します。
I just wanted to add one thing to what Hal said, and, and, and that's because as what we're finding in the ICU setting is that there are so many different things that are going on, that sometimes this type of information can be lost because of the volumes of other data that's being reviewed and being considered in the management of patients.
私の方から補足です。ICUでは多くのデータを参考にしながら、様々な治療が行われていますので、この種の情報は見落とされることがあります。
So if you or your family member winds up unfortunately in the ICU, it would be of great benefit for you to bring this particular concern to the attention of the physicians that are managing the patient because it may be flagged kind of by the pharmacy but you should not rely on that happening and this often is something that an intern or resident will add to the chart so that everyone on the team will know that this is a concern.
そのため、ご自身あるいはご家族がICUで治療を受けるということになったら、治療に当たる医師にフルオロキノロンの情報を伝えてください。医療者側もこの薬については情報を得ているとは思いますが、過信はできません。こうした情報は研修医がカルテに記入し、チーム全体で共有されるのが一般的です。
So please know that it's not a big problem if you inform the physicians that are managing the case that this is a concern.
治療にあたる医師らに事前に情報を伝えておけば、大きな問題とはなりません。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
