三甲氧苄啶-磺胺甲噁唑联合棘白菌素与单用三甲氧苄啶-磺胺甲噁唑治疗未感染人类免疫缺陷病毒患者的肺孢子虫肺炎：一项全国性回顾性队列研究。

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES

Journal of Infection and Chemotherapy Pub Date : 2024-08-06 DOI:10.1016/j.jiac.2024.08.004

Jumpei Taniguchi, Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga

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引用次数: 0

摘要

背景：尽管有报道称棘白菌素与三甲氧苄氨嘧啶-磺胺甲恶唑（TMP-SMX）联合疗法可用于治疗肺孢子菌肺炎（PCP）患者，但这种联合疗法对未感染人类免疫缺陷病毒（HIV）的PCP患者的疗效仍然未知：方法：利用日本诊断程序组合住院病人数据库中的数据，确定了在 2012 年 4 月至 2022 年 3 月期间首次因五型多氯联苯感染住院的非 HIV 患者。这些患者被分为单独接受 TMP-SMX 治疗的患者和接受 TMP-SMX 联合棘白菌素治疗的患者。我们进行了倾向分数重叠加权分析，以估算院内死亡率：在1324名符合条件的患者中，122人接受了TMP-SMX联合棘白菌素治疗，1202人接受了TMP-SMX单独治疗。倾向分数重叠加权分析显示，与单独使用TMP-SMX相比，联合疗法与降低院内死亡率无关（22.2% vs. 26.9%；风险差异，4.6%；95%置信区间，-6.1% to 15.3%；P = 0.398）：结论：在未感染艾滋病毒的患者中，棘白菌素类药物与TMP-SMX联用可能无法改善五氯苯酚引起的院内死亡率。

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Trimethoprim-sulfamethoxazole combined with echinocandins versus trimethoprim-sulfamethoxazole alone for Pneumocystis pneumonia in patients without human immunodeficiency virus infection: A nationwide retrospective cohort study.

Background: Although combination therapy of echinocandins with trimethoprim-sulfamethoxazole (TMP-SMX) has been reported for patients with Pneumocystis jirovecii pneumonia (PCP), the effectiveness of this combination therapy in patients with PCP without human immunodeficiency virus (HIV) infection remains unknown.

Methods: Data from the Japanese Diagnosis Procedure Combination inpatient database was used to identify non-HIV patients who underwent their first hospitalisation for PCP between April 2012 and March 2022. The patients were divided into those treated with TMP-SMX alone and those treated with TMP-SMX combined with echinocandins. We performed propensity-score overlap-weighting analysis to estimate in-hospital mortality.

Results: Among the 1324 eligible patients, 122 received TMP-SMX plus echinocandins, while 1202 received TMP-SMX alone. The propensity-score overlap-weighting analysis showed that the combination therapy was not associated with reduced in-hospital mortality in comparison with TMP-SMX alone (22.2 % vs. 26.9 %; risk difference, 4.6 %; 95 % confidence interval, -6.1 %-15.3 %; P = 0.398).

Conclusions: Echinocandins combined with TMP-SMX may not improve in-hospital mortality due to PCP in patients without HIV infection.

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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.