评估低剂量口服切换治疗对无并发性链球菌或肠球菌血流感染的有效性:一项回顾性队列研究
Toshiki Miwa1, Koh Okamoto1,2, Kaito Fukasawa1,3
1Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
JAC-antimicrobial resistance
|December 15, 2025
概括
低剂量口服切换疗法 (OST) 在没有肥胖症的患者中显示出治疗无并发症的格兰美阳性血流感染 (GP-BSI) 的前景. 这项研究发现,低剂量OST和静脉注射治疗之间的死亡率没有显著差异.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 口服切换疗法 (OST) 正在获得不复杂的阳性血流感染 (GP-BSI) 的吸引力.
- 对于OST的最佳剂量仍然不清楚,特别是在日本这样的地区,高剂量口服抗菌药物不被批准.
- 本研究侧重于低剂量OST在患肥胖率较低的人群中的有效性.
研究的目的:
- 调查低剂量OST对无并发性GP-BSI的有效性.
- 为了比较OST和静脉注射治疗 (IVT) 组之间的90天全因死亡率.
- 在肥胖率低的环境中评估OST.
主要方法:
- 追溯性,单一中心研究,对18岁以上的患者进行,这些患者患有不复杂的BSI,其原因是易受感染的Streptococcus或Enterococcus物种.
- 有资格接受OST的患者在主动治疗的第5天被确定.
- 使用重叠权重来比较OST和IVT组之间的90天全因死亡率.
主要成果:
- 包括172名患者 (86名OST,仅有86名IVT),BMI中位数为22.5.
- 常见的OST疗法包括阿莫西西林,阿莫西西林/克拉夫兰酸盐和勒沃弗洛克萨.
- 在OST和IVT组之间没有观察到90天全因死亡率的显著差异 (OR,0.73;95% CI,0.23-2.29).
结论:
- 低剂量OST可能是临床稳定,没有并发症的GP-BSI患者的可行选择.
- 低剂量OST的有效性建议在肥胖率低的环境中使用.
- 可能需要进一步的研究来证实这些发现.
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