假内心炎的抗菌抑制疗法在假内心炎中,尽管有指示,但在手术中被拒绝
Jérémie Tillement1, Nahema Issa2, Julien Ternacle1
1Cardiology and Cardiac Surgery Departments, Bordeaux University Hospital-Haut-Lévêque, Pessac, France.
International journal of antimicrobial agents
|May 1, 2025
概括
抑制性抗微生物疗法 (SAT) 与传统抗微生物疗法 (CAT) 相比,可能为不符合手术条件的假内心炎 (PVE) 患者提供更好的结果. 在SAT中,死亡率和住院病例显著降低,并具有良好的安全性.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
背景情况:
- 假内心炎 (PVE) 在不适合进行手术的老年患者中正在增加,导致预后不佳.
- 在这个高风险群体中,PVE的最佳抗生素策略仍未确定.
- 本研究将抑制性抗微生物治疗 (SAT) 与PVE管理的常规抗微生物治疗 (CAT) 进行比较.
研究的目的:
- 为了评估SAT与CAT对PVE患者的疗效和安全性,这些患者被拒绝接受手术.
- 评估SAT对一年全因死亡率和PVE相关住院治疗的影响.
- 确定与SAT相关的不良事件的发生率和性质.
主要方法:
- 一项前性多中心队列研究在法国西南部进行.
- 包括的患者有PVE,被拒绝接受手术,并且在最初的静脉注射治疗中幸存下来.
- 患者在初始治疗后接受了SAT或CAT治疗,结果使用Cox模型进行了比较.
主要成果:
- 分析了88名患者 (42名SAT,46名CAT);平均年龄69.4岁,并发症指数高.
- SAT与主要复合结局 (死亡率/住院) 的发生率明显较低 (HR 0.23,P=0.007).
- 在SAT组中,不良事件很少发生 (14.3%) 并且通常是轻微的,有一次停止治疗.
结论:
- 抑制性抗微生物疗法 (SAT) 似乎是不适合手术的PVE患者的安全有效选择.
- 与常规抗微生物疗法 (CAT) 相比,在这个具有挑战性的患者群体中,SAT与改善的临床结果有关.
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