早期治疗Clostridioides difficile感染:回顾性队列研究
Genady Drozdinsky1,2,3, Daniella Vronsky4,5, Alaa Atamna5,6
1Internal Medicine E, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel. gndy.dzy@gmail.com.
Internal and emergency medicine
|October 4, 2024
概括
早期对Clostridioides difficile感染 (CDI) 的抗生素治疗缩短了住院时间,但没有影响成年患者的死亡率或复发率. 本研究提供了关于CDI管理策略的见解.
科学领域:
- 传染性疾病 传染性疾病
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 困难菌感染 (CDI) 是导致传染性腹的主要原因.
- 根据有限的证据,当前的指导方针建议在怀疑CDI时使用实证抗生素,但结果迟到或严重的情况下使用实证抗生素.
- 早期CDI治疗对患者结果的影响需要进一步调查.
研究的目的:
- 评估早期开始服用抗生素对CDI成年患者的死亡率,住院时间,复发率和小肠切除率的影响.
- 评估与早期治疗相比延迟治疗的临床结果.
主要方法:
- 对796名被诊断患有CDI的成年患者进行了回顾性队列研究.
- 早期治疗定义为在便抽样后24小时内服用抗克洛斯特里迪奥伊德药物.
- 倾向性得分匹配和后勤回归用于控制混因素.
主要成果:
- 早期和延迟治疗组之间30天或90天死亡率没有显著差异.
- 在复发率,ICU入院率或切除术率方面没有观察到统计学上显著的差异.
- 接受早期治疗的患者在住院时间较短 (6天而不是8天).
结论:
- 在成年患者中,早期治疗CDI与住院时间缩短有关.
- 在便抽样后24小时内开始治疗并没有显著改变死亡率,复发率或切除术率.
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