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头孢托罗真实生活研究:西班牙多中心队列中使用头孢托罗的真实世界数据。

Cefto Real-Life Study: Real-World Data on the Use of Ceftobiprole in a Multicenter Spanish Cohort.

作者信息

Hidalgo-Tenorio Carmen, Pitto-Robles Inés, Arnés García Daniel, de Novales F Javier Membrillo, Morata Laura, Mendez Raul, de Pablo Olga Bravo, López de Medrano Vicente Abril, Lleti Miguel Salavert, Vizcarra Pilar, Lora-Tamayo Jaime, Arnáiz García Ana, Núñez Leonor Moreno, Masiá Mar, Seco Maria Pilar Ruiz, Sadyrbaeva-Dolgova Svetlana

机构信息

Unit of Infectious Diseases, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitario de Granada (IBS-Granada), 18012 Granada, Spain.

CBRN and Infectious Diseases, Hospital General Defensa Gómez Ulla, 28047 Madrid, Spain.

出版信息

Antibiotics (Basel). 2023 Jul 21;12(7):1218. doi: 10.3390/antibiotics12071218.

Abstract

BACKGROUND

Ceftobiprole is a fifth-generation cephalosporin that has been approved in Europe solely for the treatment of community-acquired and nosocomial pneumonia. The objective was to analyze the use of ceftobiprole medocaril (Cefto-M) in Spanish clinical practice in patients with infections in hospital or outpatient parenteral antimicrobial therapy (OPAT).

METHODS

This retrospective, observational, multicenter study included patients treated from 1 September 2021 to 31 December 2022.

RESULTS

A total of 249 individuals were enrolled, aged 66.6 ± 15.4 years, of whom 59.4% were male with a Charlson index of four (IQR 2-6), 13.7% had COVID-19, and 4.8% were in an intensive care unit (ICU). The most frequent type of infection was respiratory (55.8%), followed by skin and soft tissue infection (21.7%). Cefto-M was administered to 67.9% of the patients as an empirical treatment, in which was administered as monotherapy for 7 days (5-10) in 53.8% of cases. The infection-related mortality was 11.2%. The highest mortality rates were identified for ventilator-associated pneumonia (40%) and infections due to methicillin-resistant (20.8%) and (16.1%). The mortality-related factors were age (OR: 1.1, 95%CI (1.04-1.16)), ICU admission (OR: 42.02, 95%CI (4.49-393.4)), and sepsis/septic shock (OR: 2.94, 95%CI (1.01-8.54)).

CONCLUSIONS

In real life, Cefto-M is a safe antibiotic, comprising only half of prescriptions for respiratory infections, that is mainly administered as rescue therapy in pluripathological patients with severe infectious diseases.

摘要

背景

头孢比普是一种第五代头孢菌素,在欧洲仅被批准用于治疗社区获得性和医院获得性肺炎。目的是分析头孢比普甲磺酸盐(Cefto-M)在西班牙临床实践中用于住院患者或门诊肠外抗菌治疗(OPAT)感染患者的情况。

方法

这项回顾性、观察性、多中心研究纳入了2021年9月1日至2022年12月31日期间接受治疗的患者。

结果

共纳入249例患者,年龄66.6±15.4岁,其中59.4%为男性,Charlson指数为4(四分位间距2 - 6),13.7%患有新冠肺炎,4.8%入住重症监护病房(ICU)。最常见的感染类型是呼吸道感染(55.8%),其次是皮肤和软组织感染(21.7%)。67.9%的患者接受Cefto-M作为经验性治疗,其中53.8%的病例作为单一疗法给药7天(5 - 10天)。感染相关死亡率为11.2%。呼吸机相关性肺炎(40%)以及耐甲氧西林感染(20.8%)和[此处原文缺失一种感染类型](16.1%)的死亡率最高。与死亡率相关的因素是年龄(比值比:1.1,95%置信区间(1.04 - 1.16))、入住ICU(比值比:42.02,95%置信区间(4.49 - 393.4))和脓毒症/脓毒性休克(比值比:2.94,95%置信区间(1.01 - 8.54))。

结论

在现实生活中,Cefto-M是一种安全的抗生素,仅占呼吸道感染处方的一半,主要作为患有严重传染病的多病理患者的挽救治疗药物使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f907/10376387/59bf9c6cfc2c/antibiotics-12-01218-g001.jpg

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