Antibiotic therapy for acute Q fever in The Netherlands in 2007 and 2008 and its relation to hospitalization
Antibiotic therapy for acute Q fever in The Netherlands in 2007 and 2008 and its relation to hospitalization
复制标题
DOI：
10.1017/s0950268810002621
复制
发表时间：
2011-09-01
影响因子：
4.2
通讯作者：
van der Hoek, W.
中科院分区：
文献类型：
--
作者：
Dijkstra, F.;Riphagen-Dalhuisen, J.;van der Hoek, W.
临床研究中关于不同抗生素方案治疗急性Q热的有效性的数据很少。我们分析了2007年和2008年荷兰急性Q热患者的抗生素治疗方案，并评估了至少2天抗生素治疗后住院是否与初始抗生素治疗相关。急性Q热患者的抗生素治疗和危险因素的临床数据来自全科医生的病历和患者的自我报告。对于438名研究患者，多西环素是两个研究年中最常用的初始抗生素。调整混杂因素后，强力霉素（200毫克/天），氟沙星，以及其他可能有效的抗生素[包括其他新的氟喹诺酮类和多西环素（100 mg/天）]的住院风险显著低于β-内酰胺类抗生素和阿奇霉素（参考组），多西环素（200 mg/天）的风险最低（比值比0.04，95%置信区间0.01-0.22）。这些数据支持当前指南推荐强力霉素作为治疗急性Q热的首选抗生素。
Data about the effectiveness of different antibiotic regimens for the treatment of acute Q fever from clinical studies is scarce. We analysed the antibiotic treatment regimens of acute Q fever patients in 2007 and 2008 in The Netherlands and assessed whether hospitalization after a minimum of 2 days antibiotic therapy was related to the initial antibiotic therapy. Clinical data on antibiotic treatment and risk factors of acute Q fever patients were obtained from general practitioner medical records and self-reported by patients. For the 438 study patients, doxycycline was the most commonly prescribed initial antibiotic in both study years. After adjustments for confounding factors, doxycycline (200 mg/day), moxifloxacin, as well as other possibly effective antibiotics [including other new fluoroquinolones and doxycycline (100 mg/day)] showed significant lower risks for hospitalization compared to beta-lactam antibiotics and azithromycin (reference group), with the lowest risk for doxycycline (200 mg/day) (odds ratio 0.04, 95% confidence interval 0.01-0.22). These data support current guidelines that recommend doxycycline as the first choice antibiotic for treating acute Q fever.