Solomkin Joseph, Mullins C Daniel, Quintana Alvaro, Eckmann Christian, Shelbaya Ahmed, Ernst Frank R, Krukas Michelle R, Reisman Arlene
1 University of Cincinnati College of Medicine , Cincinnati, Ohio.
2 Pharmaceutical Health Services Research, University of Maryland School of Pharmacy , Baltimore, Maryland.
Surg Infect (Larchmt). 2016 Aug;17(4):402-11. doi: 10.1089/sur.2015.075. Epub 2016 Mar 16.
The utility of tigecycline as compared with other antibiotic therapies in the treatment of patients with complicated intra-abdominal infection (cIAI) and the short- and long-term outcomes of a large cohort of severely ill patients were examined. We provide the first published data on post-discharge events for these patients.
Retrospective data for the cIAI cohort were obtained from a large clinical database. Patients aged ≥18 y were selected for inclusion based on hospitalization with a relevant diagnosis code and procedure code, and guideline-compliant antimicrobial therapy. Propensity scoring was used to reduce treatment-selection bias introduced by the use of observational data. Tigecycline patients were placed into quintiles based on propensity score and were matched 1:3.
The final model based on propensity score matching included 2,424 patients: Tigecycline (n = 606) and other antibiotic therapy (n = 1,818). Treatment was successful in 426 (70.3%) tigecycline-treated patients and in 1,294 (71.2%) patients receiving other antibiotics. Similar treatment success occurred across all infection sites. Among survivors, treatment failure was associated with a greater need for all-cause re-hospitalization at 30 d and 180 d. No differences in cIAI-related re-hospitalization and discharge status were observed.
Using propensity scores to match populations, similar outcomes were demonstrated between treatment with tigecycline and other antibiotics as expressed by treatment success, the need for re-admission, similar 30-d discharge status, and the need for re-admission at 180 d.
研究了替加环素与其他抗生素疗法相比在治疗复杂性腹腔内感染(cIAI)患者中的效用,以及一大群重症患者的短期和长期结局。我们提供了这些患者出院后事件的首次发表数据。
cIAI队列的回顾性数据来自一个大型临床数据库。根据具有相关诊断代码和手术代码的住院情况以及符合指南的抗菌治疗,选择年龄≥18岁的患者纳入研究。采用倾向评分法减少因使用观察性数据而引入的治疗选择偏倚。根据倾向评分将替加环素治疗的患者分为五个五分位数,并进行1:3匹配。
基于倾向评分匹配的最终模型纳入了2424例患者:替加环素组(n = 606)和其他抗生素治疗组(n = 1818)。426例(70.3%)接受替加环素治疗的患者和1294例(71.2%)接受其他抗生素治疗的患者治疗成功。所有感染部位的治疗成功率相似。在幸存者中,治疗失败与30天和180天时因各种原因再次住院的需求增加有关。未观察到与cIAI相关的再次住院和出院状态的差异。
使用倾向评分对人群进行匹配,替加环素治疗与其他抗生素治疗在治疗成功率、再次入院需求、30天出院状态相似以及180天再次入院需求方面表现出相似的结局。