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年龄对重症患者替加环素临床疗效的影响。

Influence of age on the clinical efficacy of tigecycline in severely ill patients.

机构信息

Clinica Malattie Infettive, Dipartimento di Medicina Università di Udine and Presidio Ospedaliero Universitario Santa Maria della Misericordia, Udine, Italy.

Corporació Sanitaria del Parc Tauli, University Hospital, Sabadell, Barcelona, Spain.

出版信息

J Glob Antimicrob Resist. 2019 Sep;18:199-206. doi: 10.1016/j.jgar.2019.03.018. Epub 2019 Apr 3.

Abstract

OBJECTIVES

The aim of this study was to define the relationship between age and response to tigecycline among patients treated for complicated skin and soft-tissue infections (cSSTIs) and complicated intra-abdominal infections (cIAIs).

METHODS

Pooled data derived from five European observational studies on the use of tigecycline (July 2006-October 2011), either as monotherapy or in combination with other antibiotics, for the treatment of cSSTI or cIAI were used in the analysis.

RESULTS

The total population (N=1782 patients) was divided into three age categories: <65 years (804 patients); 65-80 years (836 patients) and >80 years (139 patients) (data unknown/missing for 3 patients). The overall mean Acute Physiology and Chronic Health Evaluation (APACHE) II score for patients with cSSTI and cIAI was 15.0±7.9 and 16.9±7.6, respectively, and the overall mean Sequential Organ Failure Assessment (SOFA) score was 5.8±3.9 and 7.0±4.2, respectively. Overall, patients with cSSTI and cIAI in the three age groups showed a good response to tigecycline treatment (76.2-80.0% and 69.2-81.1%, respectively) with patients aged ≤80 years showing higher response rates. Patients with cIAI appeared to be at greater risk for all types of adverse events compared with those with cSSTI, particularly in the older age groups.

CONCLUSION

In these real-life studies, tigecycline, either alone or in combination, achieved favourable clinical response rates in all age categories of patients with cSSTIs and cIAIs with a high severity of illness.

摘要

目的

本研究旨在确定年龄与接受治疗的复杂性皮肤和软组织感染(cSSTIs)和复杂性腹腔内感染(cIAIs)患者对替加环素的反应之间的关系。

方法

使用了来自五项关于替加环素(2006 年 7 月至 2011 年 10 月)使用的欧洲观察性研究的汇总数据,替加环素单独或与其他抗生素联合用于治疗 cSSTI 或 cIAI。

结果

总人群(N=1782 例患者)分为三个年龄组:<65 岁(804 例);65-80 岁(836 例)和>80 岁(139 例)(3 例患者数据未知/缺失)。cSSTI 和 cIAI 患者的总体平均急性生理学和慢性健康评估(APACHE)II 评分分别为 15.0±7.9 和 16.9±7.6,总体平均序贯器官衰竭评估(SOFA)评分分别为 5.8±3.9 和 7.0±4.2。总体而言,三个年龄组的 cSSTI 和 cIAI 患者对替加环素治疗的反应良好(分别为 76.2-80.0%和 69.2-81.1%),≤80 岁的患者的反应率更高。与患有 cSSTI 的患者相比,患有 cIAI 的患者似乎面临着更高的各种不良事件风险,尤其是在年龄较大的年龄组中。

结论

在这些真实世界的研究中,替加环素单独或联合使用,在患有 cSSTIs 和 cIAIs 的所有年龄段的患者中均取得了良好的临床反应率,且疾病严重程度较高。

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