部分口服治疗感染性内心炎的临床实施:丹麦POETry研究
Mia Marie Pries-Heje1, Julie Glud Hjulmand1, Ingrid Try Lenz1
1Department of Cardiology, The Heart Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
European heart journal
|October 25, 2023
概括
感染性内心炎 (IE) 的部分口服治疗内心炎 (POET) 方案显示出可行和安全的临床实施. 虽然没有统计学意义,但IE患者的口服逐步降低疗法导致数量较低的死亡率和更短的住院时间.
科学领域:
- 感染性内心炎 (IE) 是一种感染性内心炎.
- 抗生素治疗 抗生素治疗
- 临床实施 临床实施
背景情况:
- 部分口服治疗内心炎 (POET) 试验表明,口服逐步降低抗生素治疗 (PO) 与持续静脉注射 (IV) 治疗稳定左侧传染性内心炎 (IE) 的不劣.
- 这项研究评估了POET口服逐步下调方案的第一个指导方针驱动的临床实施.
研究的目的:
- 检查在现实临床环境中实施POET口服降级抗生素治疗方案的可行性和安全性.
- 为了比较接受口服逐步降低治疗的患者和接受常规静脉注射治疗IE的患者之间的结果.
主要方法:
- 在2019年5月至2020年12月期间被诊断患有IE的患者被考虑在医生的裁量下进行口服逐步降低治疗.
- 主要结局是血栓事件,无计划的心脏手术,复发性细菌病和6个月内全因死亡率的复合.
- 记录了患者的特征,治疗分配 (PO与IV),以及结果.
主要成果:
- 在562名符合条件的IE患者中,240人 (43%) 接受了PO治疗,322人 (57%) 接受了IV治疗.
- 在IV组中,有更多的患者患有S. aureus IE,心内,起器或之前的手术治疗.
- 主要组合结局发生在PO组的13%和IV组的18% (P=.051). 所有原因的死亡率在PO组为8%,而IV组为14% (P=.024). 在PO群体中,入住时间的中位数显著较短 (24天与43天,P<.001).
结论:
- 对IE的POET口服降级方案的临床实施是可行的,近一半的符合条件的候选人接受了它.
- 第四组有更多的风险因素,而PO组的初级结果和死亡率在数值上较低,但这些差异在统计学上并不显著.
- 在PO组中观察到的死亡率降低可能受到选择偏差的影响;然而,该疗法在减少住院时间方面似乎是安全有效的.
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