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    標題: Clinical Benefit of Empiric High-Dose Levofloxacin Therapy for Adults With Community-onset plates Enterobacteriaceae Bacteremia
    作者: Lee, Ching-Chi
    Yang, Chao-Yung
    Lee, Chung-Hsun
    Hsieh, Chih-Chia
    Hong, Ming-Yuan
    Hung-Jen Tang(湯宏仁)
    Ko, Wen-Chien
    貢獻者: Tainan Sin Lau Hosp, Dept Adult Crit Care Med
    Chang Jung Christian Univ, Coll Hlth Sci, Grad Inst Med Sci
    Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Emergency Med
    Natl Cheng Kung Univ, Coll Med, Dept Med
    Chi Mei Med Ctr, Dept Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Internal Med
    關鍵字: bacteremia
    defervescence
    empiric therapy
    Enterobacteriaceae
    high-dose
    levofloxacin
    日期: 2019-10
    上傳時間: 2020-07-29 13:48:19 (UTC+8)
    出版者: ELSEVIER
    摘要: Purpose: Levofloxacin is commonly prescribed to treat varied community-acquired gram-negative infections; knowledge of the therapeutic efficacies of high-dose (HD) administration is helpful to improve patient care. Methods: In this 6-year cohort, adults with community-onset Enterobacteriaceae bacteremia were retrospectively studied in 2 hospitals. To overcome the confounding factors in the dosage choice of empiric administration, patients receiving empiric intravenous HD (750 mg/d) therapy were matched with those receiving the conventional dose (CD; 500 mg/d) by using individual propensity scores, calculated by the independent predictors of 30-day crude mortality. Findings: Initially, more patients with critical illness (Pitt bacteremia score [PBS] >= 4) at bacteremia onset and comorbid malignancies and the higher 15- and 30-day mortality rate were recorded in 136 patients receiving HD therapy, compared to 103 receiving CD therapy. After appropriate matching, differences in patient demographic and clinical characteristics between the HD (n = 103) and CD (n = 103) groups were nonsignificant. Consequently, crude mortality rates at 3, 15, or 30 days after onset of bacteremia did not differ. However, the period of time to defervescence, total intravenous antimicrobial administration, and hospital stay was shorter in the HD group than in the CD group. Similarly, regardless if patients had more critical illness (PBS >= 2) or stabilized illness (PBS <2), the advantage of empiric HD therapy on defervescence remained significant. Within 60 days after discontinuation of intravenous levofloxacin therapy, the proportion of recurrent bacteremia, posttreatment overall infections, and posttreatment crude mortality was similar between the HD and CD groups. (C) 2019 Published by Elsevier Inc.
    關聯: Clinical the rapeutics, v.41, n.10, pp.1996-2007
    Appears in Collections:[保健營養系(所) ] 期刊論文

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