Will Carns , Richard Arndt , Sara Ausman , Jason Beckermann , Kristin C. Cole , Erin Gruber , Megan Schleusner , F.N.U. Shweta , Benjamin Pierce
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引用次数: 0
摘要
背景：经验治疗复杂性憩室炎的最佳抗生素方案尚未在指南中得到很好的确立。方法：对梅奥诊所收治的322例复杂性憩室炎患者进行5年回顾性队列研究。用头孢曲松和甲硝唑治疗的89例患者与用哌拉西林/他唑巴坦治疗的233例患者的结果进行了比较。如果患者在入院期间接受其中一种治疗方案至少96小时，并且至少96小时未接受任何其他憩室炎抗生素治疗方案，则纳入患者。结果：在30天再入院或全因死亡率方面，头孢曲松和甲硝唑的综合主要结局不低于哌拉西林/他唑巴坦（21.4% vs 15.9%, P = 0.12）。30天抗生素失效（P = 0.30）和90天艰难梭菌感染率（P = 0.96）差异无统计学意义。入院前7天内接受口服抗生素治疗的患者死亡或再入院和抗生素失效的风险增加。结论：头孢曲松和甲硝唑治疗复杂性憩室炎的效果不逊于哌拉西林/他唑巴坦。
Clinical impacts of utilizing ceftriaxone and metronidazole versus piperacillin/tazobactam in patients diagnosed with complicated diverticulitis
Background
The optimal antibiotic regimen to empirically treat complicated diverticulitis has not been well established in guidelines.
Methods
A 5-year retrospective cohort study was conducted with 322 patients admitted to Mayo Clinic hospitals for complicated diverticulitis. Outcomes for 89 patients treated with ceftriaxone and metronidazole were compared to 233 patients treated with piperacillin/tazobactam. Patients were included if they received one of the treatment options for at least 96 h during hospital admission and did not receive any other diverticulitis antibiotic treatment regimen for at least 96 h.
Results
Ceftriaxone and metronidazole was found to be non-inferior to piperacillin/tazobactam for the combined primary outcome of 30-day readmission or all-cause mortality (21.4 % vs 15.9 %, P = 0.12). No significant differences were found for 30-day antibiotic failure (P = 0.30) or 90-day Clostridioides difficile infection rate (P = 0.96). Patients who received oral antibiotic therapy in the 7 days prior to admission were found to have increased risk of mortality or readmission and antibiotic failure.
Conclusions
Ceftriaxone and metronidazole showed non-inferior outcomes to piperacillin/tazobactam for treating complicated diverticulitis.
期刊介绍：
The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.
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