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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31592


    標題: Clinical Benefit of Appropriate Empirical Fluoroquinolone Therapy for Adults with Community-Onset Bacteremia in Comparison with Third-Generation-Cephalosporin Therapy
    作者: Lee, Ching-Chi
    Wang, Jiun-Ling
    Lee, Chung-Hsun
    Hsieh, Chih-Chia
    Hung, Yuan-Pin
    Hong, Ming-Yuan
    Tang, Hung-Jen
    Ko, Wen-Chien
    貢獻者: Madou Sin Lau Hosp, Dept Internal Med, Div Crit Care Med
    Chang Jung Christian Univ, Grad Inst Med Sci, Coll Hlth Sci
    Natl Cheng Kung Univ, Dept Internal Med,Natl Cheng Kung Univ Hosp, Coll Med
    Natl Cheng Kung Univ, Dept Med, Coll Med
    Natl Cheng Kung Univ, Dept Emergency Med,Natl Cheng Kung Univ Hosp, Coll Med
    Minist Hlth & Welf, Dept Internal Med, Tainan Hosp
    Chi Mei Med Ctr, Dept Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    關鍵字: fluoroquinolone
    third-generation cephalosporin
    empirical therapy
    community onset
    bacteremia
    defervescence
    日期: 2017-02
    上傳時間: 2018-11-30 15:49:28 (UTC+8)
    出版者: Amer Soc Microbiology
    摘要: Both fluoroquinolones (FQs) and third-generation cephalosporins (3rd-GCs) are commonly prescribed to treat bloodstream infections, but comparative efficacies between them were rarely studied. Demographics and clinical characteristics of 733 adults with polymicrobial or monomicrobial community-onset bacteremia empirically treated by an appropriate FQ (n = 87) or 3rd-GC (n = 646) were compared. A critical illness (respectively, 8.0% versus 19.0%; P = 0.01), an initial syndrome with severe sepsis (33.3% versus 50.3%; P = 0.003), or a fatal outcome at 28 days (4.6% versus 10.5%; P = 0.08) was less common in the FQ group. A total of 645 (88.0%) patients were febrile at initial presentation, and the FQ group with (FQ group versus 3rd-GC group, respectively, 7.6 days versus 12.0 days; P = 0.04) and without (3.8 days versus 5.4 days; P = 0.001) a critical illness had a shorter time to defervescence than the 3rd-GC group. By the propensity scores, 87 patients with appropriate FQ therapy were matched with 435 treated by 3rd-GC therapy at a ratio of 1: 5, and there were no significant differences in terms of bacteremia severity, comorbidity severity, major comorbidities, causative microorganisms, and bacteremia sources between groups. Moreover, crude mortality rates at 28 days (FQ group versus 3rd-GC group, respectively, 4.6% versus 7.8%; P = 0.29) did not differ significantly. However, the time to defervescence was shorter in the FQ group (4.2 +/- 3.6 versus 6.2 +/- 7.6 days; P = 0.001). Conclusively in the adults with community-onset bacteremia, appropriate empirical FQ therapy was related to shorter time to defervescence than with 3rd-GC therapy, at least for those without a critical illness.
    關聯: Antimicrobial Agents and Chemotherapy, v.61, n.2, e02174-16
    Appears in Collections:[保健營養系(所) ] 期刊論文

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