替加环素治疗艰难梭菌相关腹泻临床疗效的回顾性分析

H. Johannesmeyer, Luiza Baloyan, Kristica Kolyouthapong
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引用次数: 0

摘要

艰难梭菌感染(CDI)是美国引起院内腹泻的主要原因。有人建议将替加环素作为治疗 CDI 的潜在药物,但支持这种做法的临床数据有限。本研究的目的是确定使用替加环素是否会给 CDI 住院患者带来有临床意义的益处。本研究是一项回顾性病历审查,纳入了接受 CDI 治疗的住院患者。根据患者是否接受了标准的 CDI 抗生素治疗方案或包括替加环素在内的抗生素治疗方案,患者被分为不同的组群。主要结果是出院时的临床恢复情况。标准抗生素治疗组和替加环素治疗组分别共有 39 名和 22 名患者。两组患者在确诊 CDI 时的 ATLAS(年龄、治疗、白细胞、白蛋白、血清肌酐)评分相似,但替加环素组患者更有可能代表 CDI 复发。标准抗生素治疗组和替加环素组患者出院时的临床康复率没有差异(38.5% 对 36.4%,P = 0.8710)。这些数据并不支持常规使用替加环素治疗 CDI,但由于各组间的基线差异以及本研究的回顾性观察性质,对这些数据的解释是有限的。
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A Retrospective Analysis of the Clinical Effectiveness of Tigecycline in the Treatment of Clostridioides difficile-Associated Diarrhea
Clostridioides difficile infection (CDI) is the leading cause of nosocomial diarrhea in the United States. Tigecycline has been proposed as a potential treatment for CDI, though limited clinical data exist to support this practice. The objective of this study was to determine if the provision of tigecycline provides a clinically meaningful benefit to inpatients with CDI. This study was a retrospective chart review enrolling inpatients receiving treatment for CDI. Patients were divided into cohorts depending on whether they received a standard antibiotic therapy regimen for CDI or an antibiotic treatment regimen that included tigecycline. The primary outcome was clinical recovery at the time of hospital discharge. A total of 39 and 22 patients were included in the standard antibiotic therapy and tigecycline groups, respectively. ATLAS (Age, Treatment, Leukocyte, Albumin, Serum creatinine) scores at the time of CDI diagnosis were similar between the two groups, though patients in the tigecycline groups were more likely to represent a recurrent episode of CDI. There was no difference in the rate of clinical recovery at the time of hospital discharge between the standard antibiotic therapy and tigecycline groups (38.5% vs. 36.4%, p = 0.8710). These data do not support the routine use of tigecycline for the treatment of CDI, though interpretation is limited due to baseline differences between groups and the retrospective, observational nature of this study.
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