基于四种严重程度分类的艰难梭菌感染治疗药物的临床疗效。

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Japanese journal of infectious diseases Pub Date : 2024-09-19 Epub Date: 2024-03-29 DOI:10.7883/yoken.JJID.2023.483
Mariko Ohtani, Sadako Yoshizawa, Taito Miyazaki, Eri Kumade, Shinobu Hirayama, Maki Sakamoto, Hinako Murakami, Tadashi Maeda, Yoshikazu Ishii, Takahiro Matsumoto, Kazuhiro Tateda
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引用次数: 0

摘要

日本的艰难梭菌感染(CDI)治疗指南建议非重症病例使用甲硝唑(MNZ),重症病例使用万古霉素(VCM)。在此,我们调查了 CDI 抗菌药物的使用情况,并评估了它们在四种严重程度分类中的临床疗效以及这些分类的有效性。我们对2015年4月至2019年3月期间首次艰难梭菌毒素检测呈阳性并开始使用CDI抗菌药物的137名住院患者进行了回顾性病历审查。为了进行CDI抗菌药物的临床疗效分析和严重程度分类的验证,纳入了接受VCM或口服MNZ治疗的患者。终点为 CDI 复发率、30 天死亡率和腹泻治愈率。无论严重程度如何,VCM 组和口服 MNZ 组在 CDI 复发率(10.4% 对 12.7%,p = 0.707)、30 天死亡率(12.5% 对 5.6%,p = 0.162)和腹泻治愈率(61.9% 对 72.7%,p = 0.238)方面均无明显差异。对于非严重病例,口服 MNZ 的治疗效果良好,证实了根据日本指南进行治疗的有效性。有必要进一步研究口服 MNZ 对初发 CDI 患者的临床疗效,并评估更可取的严重程度分类。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Efficacy of Therapeutic Agents for Clostridioides difficile Infection Based on Four Severity Classifications.

Japanese guidelines recommend metronidazole (MNZ) and vancomycin (VCM) for non-severe and severe cases of Clostridioides difficile infection (CDI), respectively. In the present study, we investigated the use of CDI antimicrobials and evaluated their clinical efficacy and validity using four severity classifications. A retrospective chart review was conducted using the data of 137 inpatients with initially positive C. difficile toxin test results and the initiation of CDI antimicrobials between April 2015 and March 2019. Patients treated with VCM or oral MNZ were included for clinical efficacy analysis of CDI antimicrobials and validation of severity classifications. The endpoints were CDI recurrence, 30-day mortality, and diarrhea cure rates. No significant differences were found between the VCM and oral MNZ groups in the CDI recurrence rate (10.4% vs. 12.7%, P = 0.707), 30-day mortality rate (12.5% vs. 5.6%, P = 0.162), and diarrhea cure rate (61.9% vs. 72.7%, P = 0.238), regardless of severity. Treatment with oral MNZ for non-severe cases was promising, confirming its usefulness according to Japanese guidelines. Further investigation of the clinical efficacy of oral MNZ in patients with first-episode CDI and evaluation of the preferred severity classification are warranted.

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来源期刊
CiteScore
4.50
自引率
4.50%
发文量
172
审稿时长
2 months
期刊介绍: Japanese Journal of Infectious Diseases (JJID), an official bimonthly publication of National Institute of Infectious Diseases, Japan, publishes papers dealing with basic research on infectious diseases relevant to humans in the fields of bacteriology, virology, mycology, parasitology, medical entomology, vaccinology, and toxinology. Pathology, immunology, biochemistry, and blood safety related to microbial pathogens are among the fields covered. Sections include: original papers, short communications, epidemiological reports, methods, laboratory and epidemiology communications, letters to the editor, and reviews.
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