Alotaibi Sultan, Damfu Nader, Alnefaie Ahmed, Alqurashi Abdullah, Althagafi Sami, Alotaibi Aown, Alotaibi Musim, Alsuwat Abdullah
Department of Pharmaceutical Care Services, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Jeddah 22384, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah 22384, Saudi Arabia.
Pharmacy (Basel). 2024 Sep 26;12(5):147. doi: 10.3390/pharmacy12050147.
Obesity is considered a health issue associated with increased morbidity and a risk factor for multiple conditions, such as type 2 diabetes, cardiovascular diseases and infections. It may affect the pharmacokinetics and pharmacodynamics of many drugs, including antimicrobials like ciprofloxacin. Regrettably, data on ciprofloxacin's efficacy in obese patients remain scarce. This study aims to evaluate the impact of obesity on the efficacy of ciprofloxacin in treating Gram-negative bacterial infections.
A retrospective multicenter cohort study was conducted in two tertiary hospitals in Saudi Arabia. Adult patients (≥18 years) treated with ciprofloxacin for confirmed Gram-negative infection between January 2017 and April 2023 were included. Patients were excluded if they received ciprofloxacin empirically, had inadequate source control within 72 h, or had missing weight and height information at ciprofloxacin initiation. The primary outcome was clinical cure, defined as the resolution of the clinical infection manifestations without additional therapeutic management by the end of treatment. Other secondary and safety outcomes were also assessed.
A total of 99 patients were included, divided into obese ( = 42) and non-obese ( = 57) groups. The obese group had a significantly lower median age (50 years) compared to the non-obese group (64 years) ( = 0.002). The obese group had fewer male patients (38.10% vs. 68.42%; = 0.004), higher body weight (90 (81-97) vs. 63 (55-70) days; < 0.001), and lower height (158 (155-165) vs. 165 (158-172) days; = 0.008) compared to non-obese. Urinary tract infection was the most common type, with being the most common isolate. The median hospital length of stay was shorter in the obese group than in the non-obese group (1 vs. 3 days, = 0.007). There were no significant differences in clinical cure rates between obese (85.71%) and non-obese (85.96%) patients ( = 1). No significant differences were observed in terms of in-hospital mortality, 30-day mortality, or 60-day infection recurrence rates between the two groups. Microbiological eradication was not achieved in the obese group, whereas a 10.53% eradication rate was observed in the non-obese group ( = 0.037). However, the majority of the patients had indeterminate eradication. The incidence of adverse drug reactions (ADRs) was lower in the obese group (4.76%) compared to the non-obese group (17.54%, = 0.066).
Treatment with ciprofloxacin in obese patients has similar efficacy and safety outcomes compared to non-obese patients with infections due to Gram-negative pathogens.
肥胖被视为一个与发病率增加相关的健康问题，也是多种疾病的风险因素，如2型糖尿病、心血管疾病和感染。它可能会影响许多药物的药代动力学和药效学，包括环丙沙星等抗菌药物。遗憾的是，关于环丙沙星在肥胖患者中的疗效数据仍然稀少。本研究旨在评估肥胖对环丙沙星治疗革兰氏阴性菌感染疗效的影响。
在沙特阿拉伯的两家三级医院进行了一项回顾性多中心队列研究。纳入2017年1月至2023年4月期间接受环丙沙星治疗确诊革兰氏阴性感染的成年患者（≥18岁）。如果患者经验性使用环丙沙星、在72小时内源控制不充分或在开始使用环丙沙星时体重和身高信息缺失，则将其排除。主要结局是临床治愈，定义为在治疗结束时无需额外治疗管理即可解决临床感染表现。还评估了其他次要结局和安全性结局。
共纳入99例患者，分为肥胖组（n = 42）和非肥胖组（n = 57）。肥胖组的中位年龄（50岁）显著低于非肥胖组（64岁）（P = 0.002）。肥胖组男性患者较少（38.10%对68.42%；P = 0.004），体重较高（90（81 - 97）对63（55 - 70）天；P < 0.001），身高较低（158（155 - 165）对165（158 - 172）天；P = 0.008）。尿路感染是最常见的类型，大肠埃希菌是最常见的分离株。肥胖组的中位住院时间比非肥胖组短（1天对3天，P = 0.007）。肥胖患者（85.71%）和非肥胖患者（85.96%）的临床治愈率无显著差异（P = 1）。两组在院内死亡率、30天死亡率或60天感染复发率方面未观察到显著差异。肥胖组未实现微生物清除，而非肥胖组的清除率为10.53%（P = 0.037）。然而，大多数患者的清除情况不确定。肥胖组的药物不良反应（ADR）发生率低于非肥胖组（4.76%对17.54%，P = 0.066）。
与非肥胖的革兰氏阴性病原体感染患者相比，肥胖患者使用环丙沙星治疗具有相似的疗效和安全性结局。
