GUT: 利福昔明治疗艰难梭菌感染的疗效分析

2018-10-06 MedSci MedSci原创

艰难梭菌感染(CDI)在大约四分之一的初治患者中会复发。一项单中心研究表明,使用“后续”利福昔明治疗可以减少这种情况的发生。、因此,研究人员就此进行了一项前瞻性试验来评估利福昔明治疗预防复发的疗效。

背景及目的
艰难梭菌感染(CDI)在大约四分之一的初治患者中会复发。一项单中心研究表明,使用“后续”利福昔明治疗可以减少这种情况的发生。因此,研究人员就此进行了一项前瞻性试验来评估利福昔明治疗预防复发的疗效。

方法
本项研究为一项多中心,随机,安慰剂对照试验,试验者均患有艰难梭菌感染并使用甲硝唑或万古霉素治疗,在CDI检测阴性后后立即招募年龄≥18岁的患者,参与者每天三次接受利福昔明400mg,持续2周,每天三次减少至200mg,再持续2周或相同的安慰剂的治疗。主要观察终点是12周内CDI复发情况。

结果
2012年12月至2016年3月期间,共有151名参与者被随机分配到利福昔明治疗组或安慰剂组。受试者的平均年龄为71.9岁(标准差15.3)。分配到安慰剂的参与者在12周内复发率为29.5%(18/61),而分配到利福昔明组的患者的复发率为15.9%(11/69),组间差异为13.7%(95%CI -28.1%至0.7%, p= 0.06)。风险比为0.54(95%CI 0.28至1.05,p = 0.07)。在为期6个月的安全性随访期间,两组各有9名参与者死亡(12%)。不同组间的不良事件发生率相似。

结论
虽然CDI治疗清楚后继续使用利福昔明可使复发率减半,但因为本项研究未能达到老年患者的招募目标,因此利福昔明的估计疗效缺乏准确性,但也能反映出一定的相关性。

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    2018-10-06 13718711b3m

    学习了,很不错的临床经验,实用性强,获益匪浅,感谢分享!

    0

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    2018-10-06 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0