Oral vs Intravenous Discharge Antibiotic Regimens in the Management of Intra-abdominal Abscesses in Penetrating Crohn's Disease.
Oral vs Intravenous Discharge Antibiotic Regimens in the Management of Intra-abdominal Abscesses in Penetrating Crohn's Disease.
复制标题
口服与静脉排出抗生素治疗穿透性克罗恩病腹内脓肿的治疗方案。
DOI：
10.1093/ibd/izad299
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发表时间：
2023
影响因子：
4.9
通讯作者：
Chang,Shannon
中科院分区：
文献类型：
--
作者：
Fansiwala,Kush;Rusher,Alison;Shore,Brandon;Herfarth,HansH;Barnes,Edward;Kochar,Bharati;Chang,Shannon
背景抗生素是治疗克罗恩病（CD）腹腔内脓肿的基础。然而，抗生素给药的最佳途径研究得很少。我们的目的是比较因CD腹腔脓肿住院并接受口服（PO）或静脉（IV）抗生素治疗的患者的手术和非手术再入院结果。方法从3个机构获得了因腹腔脓肿住院的CD患者的数据2010年1月至2020年12月。获得基线患者特征。关注的主要结局包括需要手术和出院后1年内再次入院。我们采用多变量logistic回归模型和考克斯回归分析，以调整脓肿大小，既往手术史，穿透性疾病史，和aging.ResultsWe确定了99例出院抗生素（PO = 74，IV = 25）。 IV组12个月时CD相关再入院的可能性较低（40% vs 77% PO，P= 0.01），IV组显示非手术再入院的风险随时间降低（风险比，0.376; 95%置信区间，0.176-0.802）。 两组的手术要求相似。有没有差异，在手术的时间groups.ConclusionsIn这一回顾性，多中心队列的CD患者腹腔内脓肿，手术结果是相似的患者接受PO与IV抗生素在出院。静脉注射抗生素治疗的患者非手术再入院的风险降低。需要进一步的前瞻性试验来更好地描述穿透性CD患者的最佳抗生素给药途径。
BackgroundAntibiotics are a cornerstone in management of intra-abdominal abscesses in Crohn’s disease (CD). Yet, the optimal route of antibiotic administration is poorly studied. We aimed to compare surgical and nonsurgical readmission outcomes for patients hospitalized for intra-abdominal abscesses from CD discharged on oral (PO) or intravenous (IV) antibiotics.MethodsData for patients with CD hospitalized for an intra-abdominal abscess were obtained from 3 institutions from January 2010 to December 2020. Baseline patient characteristics were obtained. Primary outcomes of interest included need for surgery and hospital readmission within 1 year from hospital discharge. We used multivariable logistic regression models and Cox regression analysis to adjust for abscess size, history of prior surgery, history of penetrating disease, and age.ResultsWe identified 99 patients discharged on antibiotics (PO = 74, IV = 25). Readmissions related to CD at 12 months were less likely in the IV group (40% vs 77% PO,P= .01), with the IV group demonstrating a decreased risk for nonsurgical readmissions over time (hazard ratio, 0.376; 95% confidence interval, 0.176-0.802). Requirement for surgery was similar between the groups. There were no differences in time to surgery between groups.ConclusionsIn this retrospective, multicenter cohort of CD patients with intra-abdominal abscess, surgical outcomes were similar between patients receiving PO vs IV antibiotics at discharge. Patients treated with IV antibiotics demonstrated a decreased risk for nonsurgical readmission. Further prospective trials are needed to better delineate optimal route of antibiotic administration in patients with penetrating CD.