Enterococcus faecalis 传染性内心炎:一项关于 gentamicin 治疗时间和结果之间的关系的试点研究
Anders Dahl1, Rasmus V Rasmussen, Henning Bundgaard
1Department of Cardiology, University Hospital of Copenhagen, Gentofte, Denmark. andersdahl2000@yahoo.dk
Circulation
|April 2, 2013
概括
对肠球菌感染性内心炎的短时间 gentamicin 治疗是有效的,对脏更安全. 一项试点研究发现,为期2周的 gentamicin 治疗足够,与较长时间治疗相比,功能得到改善.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 丹麦感染性内心炎的指导方针在2007年因aminoglycoside毒性而改变.
- 对肠球菌感染性内心炎的 جنت辛治疗时间从4-6周减少到2周.
研究的目的:
- 为了比较Enterococcus faecalis感染性内心炎在指导方针变更之前和之后的治疗结果.
- 为了评估两周的 gentamicin 治疗方案的安全性和有效性.
主要方法:
- 试点研究比较84名患有E. faecalis内心炎的患者 (2002-2011).
- 患者被分为两组:在2007年1月 (41) 之前和 (43) 之后接受治疗.
- 主要结局是1年无事件生存期;功能 (eGFR) 也被评估.
主要成果:
- 两组之间1年无事件生存率没有显著差异 (66%与69%,P=0.75).
- 在2007年之前接受治疗的患者接受了更长时间的 gentamicin (28 vs. 14天,P<0.001).
- 较短时间的治疗组在出院时具有更好的功能 (eGFR 66与45毫升/分钟,P=0.008) 和较少的eGFR下降 (1与11毫升/分钟,P=0.009).
结论:
- 两周的 gentamicin 治疗似乎足以治疗非高水平的氨基糖化物耐药性 E. faecalis 内心炎.
- 较长的 جنت米辛持续时间与更差的功能有关.
- 需要进一步的随机对照试验来证实这些发现.
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