Jandourek Alena, Smith Alexander, Llorens Lily, Thye Dirk A, Eckburg Paul B, Friedland H David
Director, Clinical Development; Cerexa, Inc., Oakland, CA.
Hosp Pract (1995). 2014 Feb;42(1):75-8. doi: 10.3810/hp.2014.02.1094.
Few publications of prospective studies have described patient outcomes in community-acquired bacterial pneumonia (CABP)-associated bacteremia. Our objective, in performing this subgroup analysis, was to assess outcomes in subjects with CABP-associated bacteremia in 2 randomized, double-blind clinical studies comparing treatment with ceftaroline fosamil versus ceftriaxone.
Our analysis summarizes baseline subject demographics, distribution of baseline pathogens isolated from blood cultures, clinical response rates at Day 4, and clinical cure rates at end of therapy and test of cure (8 to 15 days after end of therapy) in subjects with bacteremic CABP in the ceFtarOline Community-acquired pneUmonia trial vS ceftriaxone in hospitalized patients (FOCUS) studies.
In the FOCUS studies, 23 of 614 patients in the ceftaroline fosamil-treated group and 22 of 614 patients in the ceftriaxone-treated group had CABP-associated bacteremia. Baseline demographics were similar between groups. Streptococcus pneumoniae was the most common baseline bloodstream isolate. For subjects with CABP-associated bacteremia, clinical response/cure rates were similar at Day 4 (60.9% vs 59.1%), end of therapy (69.6% vs 72.7%), and test of cure (69.6% vs 68.2%) for ceftaroline fosamil and ceftriaxone, respectively.
In subjects with CABP-associated bacteremia, ceftaroline fosamil demonstrated similar clinical outcomes at Day 4, end of therapy, and test of cure compared with ceftriaxone.
前瞻性研究中很少有出版物描述社区获得性细菌性肺炎(CABP)相关菌血症患者的预后情况。我们进行这项亚组分析的目的是在两项随机、双盲临床研究中评估CABP相关菌血症患者的预后,这两项研究比较了头孢洛林酯与头孢曲松的治疗效果。
我们的分析总结了在头孢洛林社区获得性肺炎试验与住院患者头孢曲松对照研究(FOCUS)中,菌血症性CABP患者的基线受试者人口统计学数据、从血培养中分离出的基线病原体分布、第4天的临床反应率、治疗结束时的临床治愈率以及治愈测试(治疗结束后8至15天)情况。
在FOCUS研究中,头孢洛林酯治疗组的614例患者中有23例、头孢曲松治疗组的614例患者中有22例发生了CABP相关菌血症。两组之间的基线人口统计学数据相似。肺炎链球菌是最常见的基线血流分离菌。对于CABP相关菌血症患者,头孢洛林酯和头孢曲松在第4天(分别为60.9%对59.1%)、治疗结束时(分别为69.6%对72.7%)和治愈测试时(分别为69.6%对68.2%)的临床反应/治愈率相似。
在CABP相关菌血症患者中,与头孢曲松相比,头孢洛林酯在第4天、治疗结束时和治愈测试时显示出相似的临床结果。