长时间暴露于抗生素和喘恶化,死亡率和医疗保健费用
Hyun Woo Lee1, Kyungjoo Kim2, Jung-Kyu Lee1
1Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea.
Scientific reports
|October 3, 2025
概括
在成人喘患者中,长期使用抗生素与更严重的恶化,更高的死亡率和增加的医疗保健成本有关. 限制抗生素暴露可能会改善患者的治疗结果,并减少医疗保健负担.
科学领域:
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 喘恶化是导致疾病,死亡和医疗保健费用的主要原因.
- 对喘恶化的抗生素使用很常见,但缺乏明确的益处证据,并带有风险.
研究的目的:
- 检查先前抗生素暴露时间与成人喘患者的结果之间的关联.
- 评估长期使用抗生素对恶化,死亡率和医疗保健成本的影响.
主要方法:
- 以回顾性队列研究,使用2020-2022年的索赔数据.
- 将549,425名成人喘患者分为扩展 (≥4周) 和有限 (<4周) 抗生素暴露组.
- 分析了与中度至严重恶化的关联,所有原因的死亡率和医疗保健总成本.
主要成果:
- 长时间使用抗生素与恶化病例增加25% (aOR=1.25) 和死亡风险增加近一倍 (aOR=1.99) 相关.
- 长时间暴露的患者的医疗费用显着更高 (中位数为7,433美元与5,471千韩元).
- 观察到一种剂量-反应关系:更长的持续时间,更高的剂量和更多类型的抗生素与更糟糕的结果相关.
结论:
- 在成人喘患者中,长期使用抗生素与不良结果有关,包括恶化,死亡率和医疗保健成本的增加.
- 特定的并发症,如鼻炎/鼻腔炎,可能会减轻风险,而支气管切除症可能会放大风险.
- 因果关系需要进一步调查,因为观察数据可能存在偏差.
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