口服抗生素逐步降低治疗非葡萄球菌血流阳性血红菌感染
Kelvin Gandhi1, Magdalena Wrzesinski1, Kristen Bunnell2
1Department of Pharmacy, Froedtert Hospital, Milwaukee, WI, USA.
口服逐步降低疗法与静脉注射 (IV) 治疗格兰美阳性血流感染 (GP-BSI) 的疗法相比没有劣势. 这种方法表明,GP-BSI患者的临床失败发生率较低.
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.
- 临床医学 临床医学
背景情况:
- 血流感染 (BSI) 传统上是通过静脉注射 (IV) 抗生素进行管理的.
- 优化抗生素治疗的持续时间和途径对于患者的治疗结果和资源管理至关重要.
研究的目的:
- 为了评估口服逐步降低疗法的非劣势性,与格兰美阳性血流感染 (GP-BSI) 的IV疗法相比.
- 评估不同治疗途径管理的GP-BSI的临床结果和治疗有效性.
主要方法:
- 从2017年到2019年对非葡萄球菌GP-BSI患者进行了回顾性队列研究.
- 接受IV治疗的患者和过渡到口服逐步降低治疗的患者之间的结局比较.
- 主要终点:90天全因死亡率和临床失败的组合.
主要成果:
- 口服降级疗法对GP-BSI的IV疗法没有劣势.
- 口服降级组显示,90天临床失败的发生率显著降低 (9%vs14%;P<0.001).
- 输液治疗组经历了更长的住院时间 (6天 vs 4天;P < 0.001),二次结局没有显著差异.
结论:
- 口服降级疗法是选择GP-BSI的长时间静脉治疗的安全有效替代方案.
- 过渡到口服治疗可能会减少住院时间,而不会影响患者的安全.
- 进一步的研究可以探索GP-BSI管理中口服逐步降低疗法的成功预测因素.
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