Bader Mazen S, Twells Laurie, Hawboldt John
Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada.
South Med J. 2011 Dec;104(12):789-93. doi: 10.1097/SMJ.0b013e3182387365.
Once-daily intravenous cefazolin with probenecid is used commonly to treat cellulitis. The primary objective of this study was to determine the risk factors of treatment failure with this regimen.
This was a retrospective cohort study of adult outpatients with cellulitis who were initially treated with once-daily intravenous cefazolin plus probenecid. Treatment failure is defined as inadequate improvement that necessitates either hospital admission or a change in antibiotic therapy to a different intravenous regimen. A stepwise logistic regression analysis was performed to determine the risk factors for regimen failure.
From January 2003 to December 2008, 159 patients with cellulitis were initially treated with once daily intravenous cefazolin plus probenecid. Thirty-five (22%) patients had treatment failure. The treatment for 53% (9/17) of the patients with a history of chronic venous disease (CVD) failed, whereas the treatment for 18% (26/142) of patients without CVD failed (P = 0.001). Multivariate analysis identified the presence of CVD as the only risk factor associated with treatment failure (odds ratio 4.4, 95% confidence interval 1.5-13; P = .007).
Patients with cellulitis and CVD who are being treated with once-daily intravenous cefazolin plus probenecid should be monitored closely for treatment failure.
每日一次静脉注射头孢唑林加丙磺舒常用于治疗蜂窝织炎。本研究的主要目的是确定该治疗方案治疗失败的风险因素。
这是一项针对蜂窝织炎成年门诊患者的回顾性队列研究，这些患者最初接受每日一次静脉注射头孢唑林加丙磺舒治疗。治疗失败定义为改善不足，需要住院或改变抗生素治疗方案为不同的静脉用药方案。进行逐步逻辑回归分析以确定治疗方案失败的风险因素。
2003年1月至2008年12月，159例蜂窝织炎患者最初接受每日一次静脉注射头孢唑林加丙磺舒治疗。35例（22%）患者治疗失败。有慢性静脉疾病（CVD）病史的患者中53%（9/17）治疗失败，而无CVD的患者中18%（26/142）治疗失败（P = 0.001）。多变量分析确定CVD的存在是与治疗失败相关的唯一风险因素（比值比4.4，95%置信区间1.5 - 13；P = 0.007）。
接受每日一次静脉注射头孢唑林加丙磺舒治疗的蜂窝织炎合并CVD患者应密切监测治疗失败情况。
