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革兰氏阴性非 HACEK 感染性心内膜炎的联合治疗与单药治疗的临床结局比较。

Clinical outcomes of combination versus monotherapy for gram negative non-HACEK infective endocarditis.

机构信息

Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

出版信息

Diagn Microbiol Infect Dis. 2021 Nov;101(3):115504. doi: 10.1016/j.diagmicrobio.2021.115504. Epub 2021 Jul 24.

Abstract

The objective of this single-center, retrospective cohort study was to identify whether combination therapy is associated with a lower rate of adverse outcomes for the treatment of Gram negative non-HACEK IE. The primary endpoint was a composite of 60-day all-cause mortality, readmission, or recurrence of bacteremia. Of the 60 patients included, 56.7% met the primary composite outcome, with 20% overall mortality at 60 days. There was no difference in the primary composite outcome of 60-day readmission, infection recurrence or mortality between groups, with 62% of patients in the monotherapy group and 50% of patients in the combination therapy group experiencing the composite outcome (P = 0.36). Despite the high mortality and complicated nature of non-HACEK Gram negative IE, this study showed no difference in 60-day bacteremia recurrence, readmission or mortality among patients treated with combination therapy or monotherapy, suggesting that monotherapy may lead to similar clinical outcomes.

摘要

这项单中心回顾性队列研究的目的是确定联合治疗是否与治疗革兰氏阴性非 HACEKIE 的不良结局发生率降低有关。主要终点是 60 天全因死亡率、再入院或菌血症复发的复合指标。在纳入的 60 名患者中,56.7%达到主要复合结局,60 天总死亡率为 20%。两组在 60 天再入院、感染复发或死亡率的主要复合结局方面无差异,单药组 62%的患者和联合治疗组 50%的患者出现复合结局(P=0.36)。尽管非 HACEK 革兰氏阴性 IE 的死亡率高且病情复杂,但本研究显示,联合治疗或单药治疗的患者在 60 天内菌血症复发、再入院或死亡率方面无差异,表明单药治疗可能导致相似的临床结局。

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