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https://ir.cnu.edu.tw/handle/310902800/30945
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| 標題: | Improved survival in patients with severe tuberculosis after exposure to fluoroquinolones |
| 作者: | Chiang, Shyh-Ren
Shieh, Jiunn-Min
Chen, Chung-Hua
Hsing, Shu-Chen
Wen, Shih-Feng
Wang, Jhi-Joung
Cheng, Kuo-Chen
Chuang, Yin-Ching |
| 貢獻者: | Chi Mei Med Ctr, Dept Internal Med
Chia Nan Univ Pharm & Sci, Dept Gen Educ
En Chu Kong Hosp, Dept Internal Med
Chi Mei Med Ctr, Dept Resp Care Sect
Chi Mei Med Ctr, Dept Med Res
Chang Jung Christian Univ, Coll Hlth Sci
Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
Chung Hwa Univ Med Technol, Dept Safety Hlth & Environm
Natl Def Med Ctr, Dept Med
Chi Mei Med Ctr Liou Ying, Dept Internal Med |
| 關鍵字: | Antibiotics
fluoroquinolone
outcomes
population-based cohort study
tuberculosis
moxifloxacin |
| 日期: | 2016 |
| 上傳時間: | 2018-01-18 11:38:27 (UTC+8) |
| 出版者: | Taylor & Francis Ltd |
| 摘要: | Background: The clinical impact of prior exposure to antibiotics on patients with tuberculosis (TB) is largely unknown. This study investigated the survival of patients with severe TB after exposure to a variety of antibiotics. Methods: A retrospective cohort study was conducted in TB patients with prior exposure to fluoroquinolones (FQs) (FQ group), to third-generation cephalosporins (CEPH group), and to third-generation penicillins (PCN group). To understand the impact of monotherapy with antibiotics on survival, patients with prior exposure to only moxifloxacin, ceftriaxone, or piperacillin were investigated. Results: Patients in the FQ group (N=401) had a significantly higher survival rate (82.5%) than patients in the CEPH (N=210) and PCN (N=172) groups (67.6% and 62.8%, respectively; both p<0.0001) at 180 d after TB diagnosis. Adjusted odds ratio (AOR) logistic regression analysis demonstrated that patients in the FQ group had significantly more favourable outcomes than those in the CEPH and PCN groups in terms of intensive care unit (ICU) admission rate (versus CEPH cohort: AOR, 1.70; 95% CI: 1.16-2.50; p=0.0067, versus PCN cohort: AOR, 3.58; 95% CI: 2.42-5.29; both p<0.0001), mechanical ventilation rate (versus CEPH cohort: AOR, 1.70; 95% CI: 1.09-2.66; p=0.0205, versus PCN cohort: AOR, 3.92; 95% CI: 2.54-6.05; both p<0.0001), and acute respiratory failure rate (versus CEPH cohort: AOR, 1.62; 95% CI: 1.07-2.45; p=0.0223, versus PCN cohort: AOR, 4.29; 95% CI: 2.86-6.43; both p<0.0001). TB patients with prior exposure to moxifloxacin (N=198) had a significantly higher survival rate (85.9%) than that of patients with exposure to ceftriaxone (N=119) and piperacillin (N=172) monotherapy (survival rates: 69.8% and 62.8%, respectively; both p<0.001). Conclusions: TB patients with prior exposure to FQs had more favourable outcomes compared with patients who had prior exposure to third-generation cephalosporins or third-generation penicillins. This study provides new insights into the impact of previous exposure to FQs on the survival of TB patients. |
| 關聯: | Infectious Diseases, v.48 n.11-12, pp.789-795 |
| 顯示於類別: | [醫務管理系(所)] 期刊論文
[通識教育中心] 期刊論文
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