我们是否应该扩大口服抗生素在传染性内心炎的使用? 这是一项ENDO-ORAL研究
Benoit Rallet1, Romane Pouy2, Claire Coutureau3
1Infectious disease department, Dijon Bourgogne University hospital, Dijon Cedex, France.
概括
转向口服治疗感染性内心炎 (IE) 是有效的,即使对于那些不符合标准试验标准的患者. 这种方法提供了超越传统静脉注射治疗的好处,改善了患者的治疗结果.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 口服治疗是选择感染性内心炎 (IE) 患者的新兴选择.
- 目前的指南,基于POET试验,有特定的资格标准.
- 口服切换疗法的现实有效性,尤其是在非试验患者中,需要进行评估.
研究的目的:
- 在现实环境中评估感染性内心炎 (IE) 转向口服治疗的有效性.
- 评估不符合POET试验条件的患者的结果.
- 为了比较纯粹静脉和口服切换疗法组之间的治疗失败率.
主要方法:
- 来自两个法国三级中心的333名成年IE患者的回顾性队列研究 (2016-2023年).
- 患者至少接受了10天有效的抗生素治疗.
- 倾向性评分分析用于比较静脉和口服切换组之间的治疗失败,包括POET不合格的患者.
主要成果:
- 在静脉注射 (n=233) 和口服转换 (n=100) 组 (HR=0.55) 之间没有发现治疗失败的显著差异.
- 在POET不合格患者小组 (44.7%的队列) 中,结果一致.
- 接受口服交换疗法的患者在医院外活着的日子显著增加 (59 vs 47天,p=0.001).
结论:
- 转向口服治疗是感染性内心炎 (IE) 管理的可行策略,超出了传统的资格标准.
- 口服切换疗法对IE患者有潜在的直接和间接益处.
- 这种方法提供了安全有效的替代方案,改善了患者的生活质量.
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