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初治患者感染治疗的短期结局和中期随访:一项回顾性观察研究。

Short-term outcomes and intermediate-term follow-up of infection treatment for naïve patients: a retrospective observational study.

机构信息

Department of Gastroenterology, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, Zhejiang, China.

Department of Gastroenterology, Huzhou Central Hospital, Huzhou, Zhejiang Province, China.

出版信息

BMJ Open. 2022 Sep 17;12(9):e062096. doi: 10.1136/bmjopen-2022-062096.

Abstract

OBJECTIVES

To explore the outcomes of infection treatments for naïve patients in the real-world settings.

DESIGN

A retrospective observational study.

SETTING

Single tertiary level academic hospital in China.

PARTICIPANTS

We identified patients initially receiving quadruple therapy for infection from 2017 to 2020 in whom eradication was confirmed (n=23 470).

PRIMARY OUTCOME

Efficacy of different initial infection treatments.

SECONDARY OUTCOME

Results of urea breath test (UBT) after eradication.

RESULTS

Among 23 470 patients who received initial treatment, 21 285 (90.7%) were treated with amoxicillin-based regimens. The median age of the patients decreased from 2017 to 2020 (45.0 vs 39.0, p<0.0001). The main treatments were therapies containing amoxicillin and furazolidone, which had an eradication rate of 87.6% (14 707/16 784); those containing amoxicillin and clarithromycin had an eradication rate of 85.5% (3577/4182). The date of treatment, age, antibiotic regimen and duration of treatment showed correlations with the failure of eradication in a multivariable logistic regression analysis. Finally, positive UBT results after eradication clustered around the cut-off value, in both the C-UBT and C-UBT.

CONCLUSIONS

The major infection treatments for naïve patients were those containing amoxicillin and furazolidone, which offered the highest eradication rate. The date of treatment, age, antibiotic regimen and duration of treatment were risk factors for the failure of eradication. Additionally, positive UBT results after eradication clustered around the cut-off value.

摘要

目的

探索真实世界中初治患者感染治疗的结局。

设计

回顾性观察性研究。

地点

中国一家三级学术医院。

参与者

我们从 2017 年至 2020 年期间确定了 23470 例接受四联疗法治疗的初治感染患者,这些患者的根除均得到确认。

主要结局

不同初始感染治疗的疗效。

次要结局

根除后尿素呼气试验(UBT)的结果。

结果

在接受初始治疗的 23470 例患者中,21285 例(90.7%)接受了基于阿莫西林的方案治疗。患者的中位年龄从 2017 年到 2020 年逐渐降低(45.0 岁比 39.0 岁,p<0.0001)。主要治疗方法是含有阿莫西林和呋喃唑酮的治疗方法,其根除率为 87.6%(14707/16784);含有阿莫西林和克拉霉素的治疗方法的根除率为 85.5%(3577/4182)。多变量逻辑回归分析显示,治疗日期、年龄、抗生素方案和治疗持续时间与根除失败相关。最后,在 C-UBT 和 C-UBT 中,根除后阳性 UBT 结果均集中在截止值附近。

结论

初治患者感染的主要治疗方法是含有阿莫西林和呋喃唑酮的治疗方法,其根除率最高。治疗日期、年龄、抗生素方案和治疗持续时间是根除失败的危险因素。此外,根除后阳性 UBT 结果集中在截止值附近。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d94/9486336/f02640907f76/bmjopen-2022-062096f01.jpg

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