常规抗生素与中度或重度胆管炎患者的短期抗生素:非劣势随机试验
Deshidi Srinu1, Jimil Shah1, Anuraag Jena1
1Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
The American journal of gastroenterology
|September 21, 2023
概括
短期使用的抗生素与较长时间使用的抗生素同样有效治疗急性胆道炎. 这项研究发现,在4天和8天的抗生素持续时间之间,临床治愈率没有显著差异.
科学领域:
- 胃肠病学和肝病学
- 传染性疾病 传染性疾病
- 临床试验 临床试验
背景情况:
- 急性胆道炎的治疗依赖于胆道疏通和抗生素.
- 排水后的最佳抗生素持续时间仍未确定.
- 需要基于证据的关于抗生素治疗持续时间的指南.
研究的目的:
- 为了比较短期与常规持续时间的抗生素治疗.
- 为了评估短期抗生素在中度至重度胆炎中的非劣势性.
- 评估临床治愈,复发和死亡率.
主要方法:
- 单中心,随机,非劣等性试验.
- 120名中度/重度胆炎患者随机分为4天 (SD) 或8天 (CD) 的抗生素治疗.
- 主要结局:临床治愈 (30日没有胆管炎复发,15日胆红素减少>50%).
主要成果:
- 临床治愈率相似:79.66% (CD) 与77.97% (SD) (P=0.822) 相比.
- 短时间的治疗显著减少了总抗生素服用日数 (4.75 vs 8.58天;P<0.001).
- 住院时间和死亡率在各组之间是可比的.
结论:
- 短期抗生素治疗 (4天) 与急性胆道炎的常规持续时间 (8天) 不逊色.
- 较短的抗生素疗程可以减少整体抗生素暴露,而不会影响临床结果.
- 这些发现支持对急性胆道炎的抗生素持续时间指南进行修订.
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