诺基诺与四环素药物结合利芬素治疗周围假肢关节感染:一项比较研究
Benoit Gachet1,2, Olivier Robineau1,2,3, Maxime Degrendel1
1Infectious Diseases Department, Gustave Dron Hospital, 155 rue du président CotyTourcoing, France.
里芬素-四环素 (RMP-TTC) 组合表现出与里芬素-诺 (RMP-FQ) 治疗周围假肢关节感染 (PJI) 的疗法相似的疗效和耐受性. 当基诺不适合PJI管理时,RMP-TTC是一种可行的替代方案.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 周围假肢关节感染 (PJIs) 主要是由阳性细菌引起的.
- 基诺 (FQs) 与利芬素 (RMP) 结合是常见的PJI治疗方法,但可能因耐药性,副作用或不耐受性而受到限制.
- 第二代四环素 (TTC) 是一个有前途的替代疗法选择.
研究的目的:
- 为了比较RMP-TTC与RMP-FQ组合在治疗葡萄球菌和链球菌PJIs中的疗效和耐受性.
- 评估两种抗生素治疗方案之间的治疗失败率和不良事件.
主要方法:
- 对105名在2013-2021年期间接受治疗的葡萄球菌/链球菌PJI患者进行了回顾性研究.
- 在2年的随访期内,RMP-FQ (n=70) 与RMP-TTC (n=35) 方案的比较.
- 使用倾向性评分权重 (IPTW) 和考克斯回归分析来比较结果并对共变量进行调整.
主要成果:
- 在IPTW调整后,在RMP-TTC和RMP-FQ组之间没有观察到治疗失败的显著差异 (aHR 0.68;95% CI 0.32-1.4).
- 对*S. aureus*和凝血酶负型葡萄球菌 (CoNS) 的亚组分析也没有显示治疗失败的显著差异.
- 在两组治疗中报告了类似的不良事件率 (20%对19%,p > 0.9).
结论:
- 在PJI治疗中,RMP-TTC治疗的疗效和安全性与RMP-FQ相比相当.
- 应考虑RMP-TTC作为PJI的潜在治疗选择,特别是当诺类药物禁用或不耐受时.
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