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产科和妇科感染中克林霉素每日剂量与标准分次剂量的比较:一项回顾性队列研究。

Daily dose of clindamycin versus standard divided doses in obstetrical and gynecological infections: a retrospective cohort study.

作者信息

Giugno Cláudia S, Silva Alice L, Fuhrich Daniele G, Rabaioli Paola S, Gonçalves Katia G, Sartor Nicole C, Savaris Ricardo F

机构信息

Departamento e Serviço de Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul - Hospital de Clínicas de Porto Alegre - Rua Ramiro Barcelos, Porto Alegre, Brazil.

出版信息

Int J STD AIDS. 2013 Nov;24(11):893-8. doi: 10.1177/0956462413487516. Epub 2013 Jul 19.

Abstract

To compare the rates of cure of septic abortion and pelvic inflammatory disease using a daily dose of clindamycin with gentamicin versus divided doses, we conducted a retrospective cohort study, where the electronic records of 661 patients who used clindamycin 1 × , 3 × or 4 ×/day (groups 1, 3 and 4, respectively) between September 2002 and August 2010 were analysed. Major outcomes included rates of cure and failure according to the clinical records. Secondary endpoints were percentage of adverse effects related to medication regimen and the prevalence of positive VDRL and HIV. Similar conditions were observed in all groups - septic abortion: 167/116/123; pelvic inflammatory disease: 73/95/87 (groups 1, 3 and 4, respectively). No significant difference was found among groups for age or for rate of cure. Rates of cure (cure/total [rate (95%CI)]) in groups 1, 3 and 4 were 236/240 [0.983 (0.957-0.993)], 205/211 [0.971 (0.939-0.986)], 203/210 [0.966 (0.932-0.983)], respectively. Days of use of clindamycin was significantly reduced in group 1, compared to groups 3 and 4 (2.6 ± 1.3 vs. 3.5 ± 2.5 vs. 3.3 ± 1.9-mean ± SD; p < 0.0001 - ANOVA), but this may be due to differences in how length of therapy was measured and not the effect on clinical cure.

摘要

为比较每日使用一次克林霉素联合庆大霉素与分次给药治疗感染性流产和盆腔炎的治愈率,我们进行了一项回顾性队列研究,分析了2002年9月至2010年8月期间使用每日1次、3次或4次克林霉素(分别为第1、3和4组)的661例患者的电子记录。主要结局包括根据临床记录得出的治愈率和失败率。次要终点是与用药方案相关的不良反应百分比以及VDRL和HIV阳性的患病率。所有组均观察到相似情况——感染性流产:167/116/123;盆腔炎:73/95/87(分别为第1、3和4组)。各年龄组间或治愈率方面未发现显著差异。第1、3和4组的治愈率(治愈数/总数[率(95%CI)])分别为236/240 [0.983(0.957 - 0.993)]、205/211 [0.971(0.939 - 0.986)]、203/210 [0.966(0.932 - 0.983)]。与第3组和第4组相比,第1组克林霉素的使用天数显著减少(2.6±1.3 vs. 3.5±2.5 vs. 3.3±1.9——均值±标准差;p<0.0001——方差分析),但这可能是由于治疗时长测量方式的差异,而非对临床治愈的影响。

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