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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/30945


    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
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