社区获得性肺炎的抗生素治疗效果。

Antibiotic treatment outcomes in community-acquired pneumonia.

出版信息

Turk J Med Sci. 2018 Aug 16;48(4):730-736. doi: 10.3906/sag-1709-144.

PMID:30119147

Abstract

BACKGROUND/AIM: The optimal empiric antibiotic regimen for patients with community-acquired pneumonia (CAP) remains unclear. This study aimed to evaluate the clinical cure rate, mortality, and length of stay among patients hospitalized with community- acquired pneumonia in nonintensive care unit (ICU) wards and treated with a β-lactam, β-lactam and macrolide combination, or a fluoroquinolone.

MATERIALS AND METHODS

This prospective cohort study was performed using standardized web-based database sheets from January 2009 to September 2013 in nine tertiary care hospitals in Turkey.

RESULTS

Six hundred and twenty-one consecutive patients were enrolled. A pathogen was identified in 78 (12.6%) patients. The most frequently isolated bacteria were S. pneumoniae (21.8%) and P. aeruginosa (19.2%). The clinical cure rate and length of stay were not different among patients treated with β-lactam, β-lactam and macrolide combination, and fluoroquinolone. Forty-seven patients (9.2%) died during the hospitalization period. There was no difference in survival among the three treatment groups.

CONCLUSION

In patients admitted to non-ICU hospital wards for CAP, there was no difference in clinical outcomes between β-lactam, β-lactam and macrolide combination, and fluoroquinolone regimens.

摘要

背景/目的：对于社区获得性肺炎（CAP）患者，最佳经验性抗生素治疗方案仍不明确。本研究旨在评估在非重症监护病房（ICU）住院并接受β-内酰胺、β-内酰胺和大环内酯类联合治疗或氟喹诺酮类治疗的 CAP 患者的临床治愈率、死亡率和住院时间。

材料和方法

本前瞻性队列研究于 2009 年 1 月至 2013 年 9 月在土耳其的 9 家三级保健医院使用标准化的基于网络的数据库表格进行。

结果

共纳入 621 例连续患者。78 例（12.6%）患者确定了病原体。最常分离的细菌是肺炎链球菌（21.8%）和铜绿假单胞菌（19.2%）。接受β-内酰胺、β-内酰胺和大环内酯类联合治疗以及氟喹诺酮类治疗的患者临床治愈率和住院时间无差异。47 例（9.2%）患者在住院期间死亡。三组治疗患者的存活率无差异。