Time to Sputum Culture Conversion and Treatment Outcomes Among Patients with Isoniazid-Resistant Tuberculosis in Atlanta, Georgia.
Time to Sputum Culture Conversion and Treatment Outcomes Among Patients with Isoniazid-Resistant Tuberculosis in Atlanta, Georgia.
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佐治亚州亚特兰大耐异烟肼结核病患者的痰培养转化时间和治疗结果。
DOI：
10.1093/cid/cix686
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Kempker,RussellR
中科院分区：
文献类型：
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作者：
Schechter,MarcosC;Bizune,Destani;Kagei,Michelle;Machaidze,Mamuka;Holland,DavidP;Oladele,Alawode;Wang,YunF;Rebolledo,PaulinaA;Ray,SusanM;Kempker,RussellR
背景肺炎支原体对大环内酯类抗生素的耐药性已在全球范围内传播。在这里，我们的目的是阐明哪种抗菌药是治疗多发性硬化症的较好药物。肺炎肺炎在对大环内酯类耐药的大流行环境中。2010年至2013年期间的肺炎是从日本诊断程序组合国家数据库中确定的。用倾向性评分分析比较接受大环内酯类、喹诺酮类和四环素类药物治疗的患者的药物转换率、住院时间(LOS)、30天死亡率和总费用。结果来自602家医院的1650例患者被分为大环内酯类药物组(n=508)、喹诺酮类药物组(n=569)和四环素类药物组(n=573)。我们发现，大环内酯组、喹诺酮组和四环素组分别有52.8%、21.8%和38.6%的患者不得不更换药物(P<；.0001)。3组患者的LOS和30d死亡率差异无统计学意义。喹诺酮组的费用最高(P=0.0062)。从喹诺酮组和四环素组产生的倾向配对(n=487×2)也表明，喹诺酮组需要更换药物的患者比例低于四环素组(21.2%比39.6%，P<；0.0001)，但在LOS、死亡率和费用方面没有显著差异。结论作为住院M的初始治疗的任何抗支原体药物在LOS和死亡率方面没有显著差异。肺炎肺炎患者，尽管喹诺酮组转换率较低。
BackgroundMycoplasma pneumoniaestrains with resistance to macrolides have been spreading worldwide. Here, we aimed to clarify which antimicrobial agent is a better treatment for patients withM. pneumoniaepneumonia in a setting with large epidemics of macrolide resistance.MethodsAdult patients hospitalized with laboratory-confirmedM. pneumoniaepneumonia from 2010 to 2013 were identified from the Japanese Diagnosis Procedure Combination national database. Drug switching, length of stay (LOS), 30-day mortality, and total costs for patients who underwent macrolide, quinolone, and tetracycline therapy were compared using propensity score analyses.ResultsEligible patients (N = 1650) from 602 hospitals were divided into the macrolide group (n = 508), quinolone group (n = 569), or tetracycline group (n = 573). We found that 52.8%, 21.8%, and 38.6% of patients in the macrolide, quinolone, and tetracycline groups, respectively, had to switch drugs (P< .0001). There was no significant difference in the LOS and the 30-day mortality rates among these 3 groups. Cost was highest in the quinolone group (P= .0062). The propensity score-matched pairs (n = 487×2) generated from the quinolone and tetracycline groups also showed a lower proportion of patients who require switches in the quinolone group than in the tetracycline group (21.2% vs 39.6%,P< .0001) but not in the LOS, mortality, and cost.ConclusionsThere were no significant differences in the LOS and mortality among any antimycoplasmal drugs as initial treatment for hospitalizedM. pneumoniaepneumonia patients despite the lower switching rate in the quinolone group.