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头孢洛林酯用于治疗肥胖患者的急性细菌性皮肤和皮肤结构感染。

Ceftaroline fosamil for the treatment of acute bacterial skin and skin structure infections in obese patients.

作者信息

Evans John D, Udeani George, Cole Phillip, Friedland H David

机构信息

Director of Pharmacy Services, CHRISTUS Spohn Hospital-Alice, Alice, TX.

出版信息

Postgrad Med. 2014 Sep;126(5):128-34. doi: 10.3810/pgm.2014.09.2807.

Abstract

BACKGROUND

Ceftaroline fosamil is a broad-spectrum antibiotic approved by the US Food and Drug Administration (FDA) for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) and community-acquired bacterial pneumonia. The Clinical Assessment Program and Teflaro Utilization Registry (CAPTURE) is a multicenter registry study of patients treated with ceftaroline fosamil in the United States for ABSSSI or community-acquired bacterial pneumonia.

OBJECTIVE

To describe the clinical effectiveness of ceftaroline fosamil in the treatment of ABSSSI in obese patients [body mass index (BMI) ≥ 30] compared with patients with a normal BMI (18.5 to ≤ 24.9).

METHODS

Data were collected at US study centers by randomly ordered chart review.

RESULTS

Data from 261 patients with a normal BMI and 690 patients with an obese BMI were collected. The percentage of males was higher in the normal BMI than in the obese category (58.2% and 49.0%, respectively). The mean and median ages at baseline were similar. Most patients (91%) were treated on a general hospital ward, and the mean and median lengths of stay were similar between the 2 groups (approximately 11 days and 7 days, respectively). A total of 73.2% of normal BMI patients and 77.5% of obese patients were discharged to home. Rates of diabetes mellitus were 26.4% in the normal BMI group and 55.1% in the obese group. Methicillin-resistant Staphylococcus aureus was isolated from 26.1% of normal BMI patients and 20.5% of obese patients (16.4% morbidly obese subset). Mean treatment duration for all patients was 5.9 days. Of patients with a normal BMI, 57.5% received ceftaroline fosamil as monotherapy as did 63.3% of obese patients. Clinical success was high in both the normal BMI (85.1%) and the obese (89.0%) groups.

CONCLUSION

Ceftaroline fosamil is an effective treatment option for obese patients with ABSSSI with a similar clinical success rate, mean and median length of stay, and discharge destination to home when compared with normal BMI patients.

摘要

背景

头孢洛林酯是一种经美国食品药品监督管理局(FDA)批准用于治疗急性细菌性皮肤及皮肤结构感染(ABSSSI)和社区获得性细菌性肺炎的广谱抗生素。临床评估项目和头孢洛林使用登记研究(CAPTURE)是一项在美国进行的多中心登记研究,纳入了接受头孢洛林酯治疗ABSSSI或社区获得性细菌性肺炎的患者。

目的

描述与体重指数(BMI)正常(18.5至≤24.9)的患者相比,头孢洛林酯治疗肥胖患者(BMI≥30)ABSSSI的临床疗效。

方法

通过随机顺序的病历审查在美国研究中心收集数据。

结果

收集了261例BMI正常患者和690例肥胖BMI患者的数据。BMI正常组男性比例高于肥胖组(分别为58.2%和49.0%)。基线时的平均年龄和中位数年龄相似。大多数患者(91%)在综合医院病房接受治疗,两组的平均住院时间和中位数住院时间相似(分别约为11天和7天)。共有73.2%的BMI正常患者和77.5%的肥胖患者出院回家。正常BMI组糖尿病发生率为26.4%,肥胖组为55.1%。26.1%的BMI正常患者和20.5%的肥胖患者(16.4%为病态肥胖亚组)分离出耐甲氧西林金黄色葡萄球菌。所有患者的平均治疗持续时间为5.9天。BMI正常的患者中,57.5%接受头孢洛林酯单药治疗,肥胖患者中这一比例为63.3%。BMI正常组(85.1%)和肥胖组(89.0%)的临床成功率均较高。

结论

与BMI正常的患者相比,头孢洛林酯是治疗肥胖ABSSSI患者的有效选择,临床成功率、平均和中位数住院时间以及出院回家的比例相似。

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