Effects of Prophylactic Antibiotics on Length of Stay and Total Costs for Pediatric Acute Pancreatitis A Nationwide Database Study in Japan
Effects of Prophylactic Antibiotics on Length of Stay and Total Costs for Pediatric Acute Pancreatitis A Nationwide Database Study in Japan
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DOI：
10.1097/mpa.0000000000001682
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发表时间：
2020-11-01
期刊：
影响因子：
2.9
通讯作者：
Yasunaga, Hideo
中科院分区：
文献类型：
--
作者：
Ikeda Kurakawa, Kayo;Okada, Akira;Yasunaga, Hideo
目的：成人急性胰腺炎（AP）指南不建议常规预防性使用抗生素，因为其在死亡率、感染并发症或住院时间方面没有临床价值。虽然儿科AP的死亡率很低，但没有研究探讨儿科患者使用抗生素的理由。本研究的目的是评估早期预防性抗生素对儿科患者住院时间和总费用的影响。方法：使用2010年至2017年的日本诊断程序组合数据库，我们使用了使用倾向评分的治疗加权法的稳定逆概率，以平衡抗生素组和对照组的背景特征，结果：抗生素治疗组（n = 652）与对照组（n = 467）住院时间比较，差异有统计学意义（11天vs 9天;百分比差异，15.4%; 95%置信区间，5.0%-26.8%）和总成本（US $4085 vs US $3648;百分比差异，19.8%; 95%置信区间，8.0%-32.9%）。结论：预防性抗生素与更长的住院时间和更高的总费用相关。我们的研究结果不支持在儿科AP人群中常规使用预防性抗生素。
Objectives: Acute pancreatitis (AP) guidelines for adult patients do not recommend routine prophylactic use of antibiotics because of no clinical merit on mortality, infectious complications, or length of stay. Although the mortality of pediatric AP is low, no studies have explored the rationale for antibiotic use in pediatric patients. The aim of this study was to evaluate the effects of early prophylactic antibiotics on length of stay and total costs in pediatric patients.Methods: Using the Japanese Diagnosis Procedure Combination database from 2010 to 2017, we used the stabilized inverse probability of treatment weighting method using propensity scores to balance the background characteristics in the antibiotics group and the control group, and compared length of stay and total costs between the groups.Results: We found significant differences between the antibiotics group (n = 652) and the control group (n = 467) in length of stay (11 days vs 9 days; percent difference, 15.4%; 95% confidence interval, 5.0%-26.8%) and total costs (US $4085 vs US $3648; percent difference, 19.8%; 95% confidence interval, 8.0%-32.9%).Conclusions: Prophylactic antibiotics were associated with longer length of stay and higher total costs. Our results do not support routine use of prophylactic antibiotics in pediatric AP populations.