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Infection:铜绿假单胞菌菌血症:氟喹诺酮类能替代β-内酰胺类吗?

2018-08-03 吴星 环球医学

铜绿假单胞菌菌血症与较高的死亡率相关,最常见的单药治疗为基于β-内酰胺类药物的治疗。2018年6月,发表在《Infection》的一项研究旨在调查明确氟喹诺酮类药物单药治疗vsβ-内酰胺类药物单药治疗在铜绿假单胞菌菌血症中的临床结局。

铜绿假单胞菌菌血症与较高的死亡率相关,最常见的单药治疗为基于β-内酰胺类药物的治疗。2018年6月,发表在《Infection》的一项研究旨在调查明确氟喹诺酮类药物单药治疗vsβ-内酰胺类药物单药治疗在铜绿假单胞菌菌血症中的临床结局。

该回顾性研究纳入了2013年11月~2014年11月在台北退伍军人总医院接受明确β-内酰胺类药物或氟喹诺酮类药物单药治疗的成年患者。通过逻辑回归和倾向得分调整分析,评估28天死亡率的独立风险因素。

结果显示,纳入的105名患者中,78人接受β-内酰胺类药物,27人接受氟喹诺酮类药物(环丙沙星20人,左氧氟沙星7人)。原发性菌血症(39.0%)和尿路感染(37.1%)是最常见的菌血症来源。氟喹诺酮类药物和β-内酰胺类药物组28天死亡率分别为11.1%和32.1%(P=0.062)。根据APACHE II和Pitt菌血症评分对组间28天死亡率进行分层后,不再具有显着性差异。倾向得分调整的多变量分析表明,氟喹诺酮类药物明确治疗与28天死亡率不相关(OR,0.42;95% CI,0.08~2.23;P=0.305)。

结果表明,鉴于体外具有活性,作为铜绿假单胞菌菌血症的明确单药治疗,氟喹诺酮类药物或是β-内酰胺类药物的替代。该研究结果可以作为进一步研究的基础,并为铜绿假单胞菌菌血症的抗生素管理干预提供可能的目标。

原始出处:

Wu PF, et al. Is fluoroquinolone monotherapy a useful alternative treatment for Pseudomonas aeruginosa bacteraemia? Infection. 2018 Jun;46(3):365-373. doi: 10.1007/s15010-018-1131-7.

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    2018-08-05 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2018-08-04 哈哈869

    挺好的学习资料,每天都可以学到新知识,每天都有新收获,谢谢分享

    0

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Infect Cont Hosp Ep:MDRO感染,有一就有二?

随着医疗技术的发展,侵袭性操作层出不穷,伴随广谱抗菌药物使用带来的不良反应,多重耐药菌(MDRO)越来越不容忽视,本文研究关注了曾经感染多重耐药菌患者因多重耐药菌感染再入院的状况。

NEJM:急性泪囊炎-病例报道

在极少数情况下,急性泪囊炎可发展为眼眶蜂窝织炎、脓肿和脑膜炎。该患者接受静脉注射抗生素,治疗第一天后发热和眼睛引流的症状均消失。对眼睛流出的液体标本进行培养得到了对甲氧西林敏感的金黄色葡萄球菌。尿液、血液和脑脊液培养结果均为阴性。

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