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替加环素治疗复杂性皮肤和软组织感染及腹腔内感染的安全性和耐受性:基于五项欧洲观察性研究的分析。

Safety and tolerability of tigecycline for the treatment of complicated skin and soft-tissue and intra-abdominal infections: an analysis based on five European observational studies.

机构信息

Hospital General de Granollers, Granollers, Spain.

出版信息

J Antimicrob Chemother. 2013 Jul;68 Suppl 2:ii37-44. doi: 10.1093/jac/dkt143.

Abstract

OBJECTIVES

Tigecycline is approved for the treatment of complicated skin and soft-tissue infections (cSSTIs) and complicated intra-abdominal infections (cIAIs) in adults. In this analysis the safety and tolerability profile of tigecycline (used alone or in combination) for the treatment of patients with approved indications of cSSTI and cIAI were examined under real-life clinical conditions.

PATIENTS AND METHODS

Individual patient-level data were pooled from five European observational studies (July 2006 to October 2011). A total of 254 cSSTI and 785 cIAI patients were included. The mean age was 63 years; 34.4% and 56.6% were in intensive care units, 90.9% and 88.1% had at least one comorbidity and mean Acute Physiology and Chronic Health Evaluation (APACHE) II scores at the beginning of treatment were 15.0 ± 7.9 and 16.9 ± 7.6, respectively.

RESULTS

Data on adverse events (AEs) were available for 198 cSSTI and 590 cIAI patients in three studies. Nausea and vomiting were reported in ≤ 2% of patients. The most common serious AEs were multi-organ failure (4.0% and 10.0% in cSSTI and cIAI patients, respectively) and sepsis (4.0% and 6.1%, respectively). Death was recorded for 24/254 (9.4%) cSSTI and 147/785 (18.7%) cIAI patients. Mortality rates were higher in the group with a baseline APACHE II score of >15 compared with those with a score of ≤ 15 (18.7% versus 3.5% for cSSTI patients and 23.8% versus 16.0% for cIAI patients). A similar trend was seen when cIAI patients were stratified by Sequential Organ Failure Assessment (SOFA) score.

CONCLUSIONS

The safety and tolerability of tigecycline, alone and in combination, are consistent with the level of critical illness among patients in these real-life studies.

摘要

目的

替加环素被批准用于治疗成人复杂性皮肤和软组织感染(cSSTIs)和复杂性腹腔内感染(cIAIs)。在本分析中,根据真实临床条件,检查了替加环素(单独使用或联合使用)治疗有批准适应证的 cSSTI 和 cIAI 患者的安全性和耐受性概况。

患者和方法

从五项欧洲观察性研究中(2006 年 7 月至 2011 年 10 月)汇集了个体患者水平的数据。共纳入 254 例 cSSTI 和 785 例 cIAI 患者。平均年龄为 63 岁;34.4%和 56.6%在重症监护病房,90.9%和 88.1%有至少一种合并症,治疗开始时平均急性生理学和慢性健康评估(APACHE)Ⅱ评分分别为 15.0±7.9 和 16.9±7.6。

结果

在三项研究中,有 198 例 cSSTI 和 590 例 cIAI 患者可提供不良事件(AE)数据。恶心和呕吐的报告发生率≤2%。最常见的严重 AE 是多器官衰竭(cSSTI 和 cIAI 患者分别为 4.0%和 10.0%)和败血症(分别为 4.0%和 6.1%)。记录了 24/254(9.4%)例 cSSTI 和 147/785(18.7%)例 cIAI 患者死亡。基线 APACHE II 评分>15 的患者死亡率高于评分≤15 的患者(cSSTI 患者分别为 18.7%和 3.5%,cIAI 患者分别为 23.8%和 16.0%)。当根据序贯器官衰竭评估(SOFA)评分对 cIAI 患者进行分层时,也观察到了类似的趋势。

结论

替加环素单独和联合使用的安全性和耐受性与这些真实研究中患者的危重程度一致。

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