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克林达米辛加上万科米辛对照线索利德用于治疗死软组织感染

Joshua Dorazio¹, Abby L Chiappelli¹, Ryan K Shields²

¹Presbyterian Hospital Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Open forum infectious diseases

|June 23, 2023

概括

通过比较死软组织感染 (NSTI) 的实证治疗方法,克林达米辛加上万科米辛的30天死亡率与linezolid相似. 然而,克林达米辛组患有更严重的损伤和死亡,AKI或C. difficile感染的复合结果.

科学领域:

传染性疾病传染性疾病
药理学药理学是指药理学的学科.
关键护理医学关键护理医学

背景情况:

末性软组织感染 (NSTI) 是一种严重的,危及生命的细菌感染,需要及时的经验性抗生素治疗.
选择最佳的经验抗生素治疗方案对于改善患者的治疗结果和最大限度地减少与治疗有关的毒性至关重要.
目前的指导方针建议广泛覆盖,包括对抗格拉姆阳性,格拉姆阴性和无气生物的活性剂.

研究的目的:

为了比较克林达米辛加万科米辛与线索利德的安全性和疗效,作为NSTIs的经验性治疗.
为了评估两组治疗之间的30天死亡率,急性损伤 (AKI) 和Clostridioides difficile感染 (CDI) 率.

主要方法:

一个回顾性,单中心,准实验性研究设计.
包括接受手术治疗的NSTI患者,并使用克林达米辛或线索立德.
对62名患者进行匹配对分析,比较治疗组之间的结果.

主要成果:

克林达米辛/万科米辛和线化物组之间30天死亡率没有显著差异 (8.06%与6.45%,P = .65).
与线化物组相比,克林达米辛/万科米辛组的AKI发病率更高 (9.68%对1.61%,P=0.05).
死亡,AKI或CDI的复合结局在克林达米辛/万科米辛组中更为频繁.

结论:

在经验性NSTI治疗中,克林达米辛加上万科米辛的30天死亡率与线索立德的30日死亡率相当.
克林达米辛和万科米辛的组合与AKI的更高风险和复合不良结果有关.
需要进一步的前性研究来证实这些发现,并指导对NSTIs的最佳实证治疗选择.

关键词:

这是NSTI的NSTI.危及生命的感染.皮佩拉西林 - 塔扎巴克坦.手术性脱bridement 进行了手术.

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