Cortés Jorge Alberto, Sierra Claudia Rocío, Sánchez Ricardo
Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Sede Bogotá, Bogotá 111321, Colombia.
Infectious Disease Service, Hospital Universitario Nacional, Sede Bogotá, Bogotá 111321, Colombia.
Antibiotics (Basel). 2024 Mar 19;13(3):274. doi: 10.3390/antibiotics13030274.
The aim of this study was to evaluate the effect of inappropriate therapy in adult patients with community-acquired pyelonephritis caused by receiving empirical treatment with cefuroxime during hospital stay and readmission. A retrospective cohort study was performed. Inappropriate treatment was considered treatment for a nonsusceptible isolate according to the results of the urine culture. Adjustment for confounding factors was performed with propensity score-derived inverse probability of treatment weighting. Between 2013 and 2020, 747 patients were included, 102 (13.7%) of whom received inappropriate therapy. Compared to appropriate therapy, inappropriate therapy was associated with a shorter length of stay in the adjusted analysis (Hazard Ratio = 0.34; 95% CI = 0.23-0.49). After 735 patients were discharged from the hospital, 66 were readmitted in the following 30 days. In comparison with appropriate therapy, inappropriate antimicrobial therapy was not related to readmission (OR 1.47; 95% CI = 0.35-2.79). Inappropriate therapy was not related to a longer hospital stay or readmission due to pyelonephritis after adjusting for confounders and covariates.
本研究的目的是评估在住院期间及再次入院时接受头孢呋辛经验性治疗的成年社区获得性肾盂肾炎患者中，不适当治疗的影响。进行了一项回顾性队列研究。根据尿培养结果，不适当治疗被认为是针对不敏感分离株的治疗。采用倾向评分衍生的治疗加权逆概率对混杂因素进行调整。在2013年至2020年期间，共纳入747例患者，其中102例（13.7%）接受了不适当治疗。在调整分析中，与适当治疗相比，不适当治疗与住院时间缩短相关（风险比=0.34；95%置信区间=0.23-0.49）。735例患者出院后，66例在接下来的30天内再次入院。与适当治疗相比，不适当的抗菌治疗与再次入院无关（比值比1.47；95%置信区间=0.35-2.79）。在对混杂因素和协变量进行调整后，不适当治疗与住院时间延长或因肾盂肾炎再次入院无关。
