皮质类固醇和细菌性脑膜炎儿童死亡率
Jillian Mongelluzzo1, Zeinab Mohamad, Thomas R Ten Have
1Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
JAMA
|May 8, 2008
概括
辅助性皮质类固醇并没有改善细菌性脑膜炎儿童的结果. 这项研究发现皮质类固醇使用与儿科患者的死亡率或出院时间之间没有显著的关联.
科学领域:
- 儿童传染病 儿童传染病
- 临床药理学 临床药理学
- 流行病学 流行病学
背景情况:
- 已知辅助性皮质类固醇可降低成人细菌脑膜炎的死亡率.
- 关于它们在儿科病例中的疗效存在相互矛盾的证据.
- 细菌性脑膜炎仍然是儿童发病率和死亡率的重要原因.
研究的目的:
- 为了研究辅助皮质类固醇和诊断为细菌性脑膜炎的儿童的临床结果之间的关联.
- 分析皮质类固醇治疗对死亡率和出院时间的影响.
- 为儿童细菌性脑膜炎中使用皮质类固醇提供基于证据的指导.
主要方法:
- 追溯队列研究涉及2780名患有细菌性脑膜炎的儿童.
- 来自美国27家三级护理儿童医院 (2001-2006) 的数据.
- 倾向性评分分析和倾向性调整的考克斯回归模型被用于评估结果.
主要成果:
- 辅助性皮质类固醇被给予8.9%的儿科患者.
- 不同年龄组使用皮质类固醇时没有观察到显著的死亡率降低.
- 皮质类固醇治疗与医院出院时间缩短无关.
结论:
- 在患有细菌性脑膜炎的儿童中,辅助性皮质类固醇治疗与降低死亡率无关.
- 这些发现表明,辅助性皮质类固醇不会显著改变儿科细菌脑膜炎的临床结果.
- 可能需要进一步的研究来澄清皮质类固醇在特定儿科脑膜炎亚型中的作用.
相关概念视频
Factors Affecting the Risk of Infection
The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
Sexually Transmitted Infections
Sexually transmitted infections (STIs) are diseases transmitted primarily through unsafe sexual interactions. Bacteria, viruses, or parasites cause them and can result in severe health complications if untreated.ChlamydiaThe bacterium Chlamydia trachomatis is responsible for the disease Chlamydia, the most common STI in the United States. This peculiar pathogen requires human cells to reproduce, residing intracellularly. The initial infection often goes unnoticed because it typically does not...
Pharmacokinetics in Pediatric Patients: Drug Excretion
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Rocky Mountain Spotted Fever
Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
Bacterial Gastroenteritis
Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid receptor...
Cholera
Cholera is an acute gastrointestinal disease caused by the Gram-negative bacterium Vibrio cholerae. It is transmitted primarily via the fecal-oral route through the ingestion of contaminated water or food.Vibrio cholerae is a motile, Gram-negative bacterium of the family Vibrionaceae, primarily associated with waterborne outbreaks in areas with inadequate sanitation. Although over 200 serogroups of V. cholerae exist, only O1 and O139 are responsible for epidemic cholera. The O1 serogroup,...


