Comparative prospective cohort study of efficacy and safety according to dosage and administration of ceftriaxone for community-acquired pneumonia.

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2024-09-07 DOI:10.1016/j.jiac.2024.09.005

Yosuke Nakanishi,Akihiro Ito,Hiromasa Tachibana,Masanori Kawataki,Tadashi Ishida

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Abstract

INTRODUCTION Limited prospective evidence has been accumulated regarding the efficacy and safety of ceftriaxone (CTRX) based on differences in dosage and administration of the drug as empiric therapy for community-acquired pneumonia (CAP). This study aimed to compare initial treatment failure, 30-day mortality, and side effects between two groups of hospitalized adult CAP patients: one receiving intravenous CTRX at 1g twice daily (1gq12hr) and the other receiving 2g once daily (2gq24hr). METHODS We prospectively included patients with CAP admitted to our hospital between October 2010 and December 2018. We analyzed patients initially treated solely with CTRX as either 1gq12hr or 2gq24hr. The primary outcome was initial treatment failure, while secondary outcomes were 30-day mortality and side effects. Inverse probability of treatment weighting (IPTW) analysis was used to minimize biases. RESULTS Among the 457 CAP patients, 186 patients were in the 1gq12hr group and 271 patients were in the 2gq24hr group. After IPTW analysis, no significant differences in initial treatment failure rate (2.43% vs 4.46%, p=0.27) or 30-day mortality rate (2.95% vs 6.43%, p=0.13) were seen between groups. A small but noteworthy tendency was noted in the frequency of side effects between the two groups (1.04% vs 4.20%, p=0.08) following IPTW analysis, even though the difference was not significant. CONCLUSIONS This study did not find any significant difference between ceftriaxone 1gq12hr and 2gq24hr regarding efficacy or safety in adult patients with CAP. However, CTRX 1gq12hr may represent a safer option in terms of side effects.

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社区获得性肺炎头孢曲松剂量和用药安全性的前瞻性队列比较研究。

简介：根据头孢曲松（CTRX）作为社区获得性肺炎（CAP）经验疗法的用药剂量和给药方式的不同，有关头孢曲松（CTRX）疗效和安全性的前瞻性证据积累有限。本研究旨在比较两组住院成年 CAP 患者的初始治疗失败、30 天死亡率和副作用：一组接受静脉注射 CTRX，剂量为 1g，每天两次（1gq12hr），另一组接受 2g，每天一次（2gq24hr）。方法我们前瞻性地纳入了 2010 年 10 月至 2018 年 12 月期间我院收治的 CAP 患者。我们分析了最初仅接受 1gq12hr 或 2gq24hr CTRX 治疗的患者。主要结果是初始治疗失败，次要结果是 30 天死亡率和副作用。结果在 457 例 CAP 患者中，1gq12hr 组有 186 例，2gq24hr 组有 271 例。经过IPTW分析，各组间初始治疗失败率（2.43% vs 4.46%，P=0.27）或30天死亡率（2.95% vs 6.43%，P=0.13）无明显差异。IPTW分析后发现，两组间的副作用发生率（1.04% vs 4.20%，P=0.08）有微小但值得注意的趋势，尽管差异不显著。不过，就副作用而言，头孢曲松 1gq12hr 可能是更安全的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Chemotherapy INFECTIOUS DISEASES-PHARMACOLOGY & PHARMACY

CiteScore

4.10

自引率

4.50%

发文量

303

审稿时长

47 days

期刊介绍： The Journal of Infection and Chemotherapy (JIC) — official journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases — welcomes original papers, laboratory or clinical, as well as case reports, notes, committee reports, surveillance and guidelines from all parts of the world on all aspects of chemotherapy, covering the pathogenesis, diagnosis, treatment, and control of infection, including treatment with anticancer drugs. Experimental studies on animal models and pharmacokinetics, and reports on epidemiology and clinical trials are particularly welcome.