Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/32647
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    標題: Short versus long duration antimicrobial treatment for community-onset bacteraemia: A propensity score matching study
    作者: Lee, Ching-Chi
    Hsieh, Chih-Chia
    Yang, Chao-Yung
    Hong, Ming-Yuan
    Lee, Chung-Hsun
    Hung-Jen Tang(湯宏仁)
    Ko, Wen-Chien
    貢獻者: Sin Lau Hosp, Dept Adult Crit Care Med
    Chang Jung Christian Univ, Coll Hlth Sci, Grad Inst Med Sci
    Natl Cheng Kung Univ Hosp, Dept Internal Med
    Natl Cheng Kung Univ Hosp, 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 Hosp, Dept Internal Med, Div Infect Dis
    關鍵字: Short-course
    Antimicrobial therapy
    Antimicrobial-resistant
    Community-onset
    Bloodstream infection
    Bacteraemia
    日期: 2019-08
    上傳時間: 2020-07-29 13:53:36 (UTC+8)
    出版者: ELSEVIER
    摘要: The efficacy and safety of short-course intravenous (i.v.) antimicrobial therapy for bloodstream infections is unknown. Therefore, a retrospective 8-year cohort study including 1431 hospitalised adults was conducted to compare the outcomes of patients receiving short-course (5-10 days) and long-course (11-16 days) i.v. antibiotic therapy for community-onset bacteraemia. Of 1010 patients who received short-course therapy, 726 were matched with 363 patients in the long-course group through propensity score matching at a ratio of 1:2 based on independent predictors of 30-day mortality identified in the multivariate regression model. Following appropriate matching, similarities between the two groups in the proportion of baseline characteristics (age, sex, major co-morbidities, co-morbidity severity, bacteraemia severity at onset and major bacteraemia sources) and 30-day crude mortality rate after bacteraemia onset were observed. Notably, clinical outcomes within 30 days after the end of i.v. therapy, in terms of proportions of post-treatment overall infections (2.2% vs. 6.1%; P = 0.001), infections caused by antimicrobial-resistant pathogens (ARPs) (1.7% vs. 4.4%; P = 0.007), and thereby post-treatment crude mortality (1.4% vs. 3.6%; P = 0.009), were lower in the short-course group. In conclusion, for adults with community-onset uncomplicated bacteraemia, short-course (5-10 days) i.v. antibiotic treatment did not result in an increased risk of mortality but instead decreased the odds of overall and ARP infections after the treatment course. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.
    關聯: International Journal of Antimicrobial Agents, v.54, n.2, pp.176-183
    显示于类别:[保健營養系(所) ] 期刊論文

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