Clinical and epidemiological advantages of culturing bacterial keratitis.
Clinical and epidemiological advantages of culturing bacterial keratitis.
复制标题
培养细菌性角膜炎的临床和流行病学优势。
DOI：
10.1097/00003226-200401000-00007
复制
发表时间：
2004
期刊：
影响因子：
2.8
通讯作者：
Schlech,BarryA
中科院分区：
文献类型：
--
作者：
Wilhelmus,KirkR;Schlech,BarryA
目的探讨角膜培养结果与溃疡性角膜炎的抗菌治疗反应率之间的关系，并确定在细菌性角膜炎的随机临床试验中，培养确认是否影响相对治疗效果。方法通过比例风险回归法评估608例溃疡性角膜炎患者中细菌培养阳性对抗菌治疗改善和治愈率的影响。用局部环丙沙星单一疗法治疗溃疡性角膜炎。荟萃回归分析评价了4项临床试验中735例患者的相对治愈率的文化确认的相互作用，比较氟喹诺酮类药物单药治疗头孢菌素和氨基糖苷类药物联合治疗。结果在一项前瞻性队列研究中，细菌性角膜炎，是培养阳性，长度超过4毫米有37%，（95%可信区间，20%，51%）缓慢的改善率和56%（95%可信区间，41%，67%）缓慢的治愈率在环丙沙星治疗期间。在随机临床试验中，文化的结果并没有修改具有类似的1周治愈rates. ConclusionsCulture确认的治疗的相对效果影响溃疡性角膜炎的抗菌治疗反应率，而不修改等效的抗菌治疗的比较效果，有利于细菌性角膜炎的临床试验的普遍性。
PurposeTo examine how the corneal culture result is associated with the antibacterial treatment response rate of ulcerative keratitis in a prospective cohort study and to determine whether culture confirmation affects the relative treatment effect in randomized clinical trials of bacterial keratitis.MethodsThe influence of a positive bacterial culture on the rates of antibacterial improvement and cure was estimated by proportional hazards regression among 608 patients with ulcerative keratitis treated with topical ciprofloxacin monotherapy. The interaction of culture confirmation on the relative cure rates of 735 patients enrolled in 4 clinical trials comparing fluoroquinolone monotherapy to combined cephalosporin and aminoglycoside therapy was evaluated by metaregression.ResultsIn a prospective cohort study, bacterial keratitis that was culture positive and longer than 4 mm had a 37%(95% confidence interval, 20%, 51%) slower improvement rate and a 56%(95% confidence interval, 41%, 67%) slower cure rate during ciprofloxacin therapy. Among randomized clinical trials, the culture result did not modify the relative effect of treatments having similar 1-week cure rates.ConclusionsCulture confirmation affects the antibacterial therapeutic response rate of ulcerative keratitis and, while not modifying the comparative effect of equivalent antibacterial treatments, facilitates generalizability of clinical trials of bacterial keratitis.