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BMJ Open Respir Res：年龄对强力霉素对COPD门诊患者急性加重生活影响的影响

2020-02-23 不详 网络

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尽管细菌对慢性阻塞性肺疾病（AECOPD）的急性加重有显着贡献，但抗生素的附加价值仍存在争议，尤其是在门诊患者中。年龄可能会影响抗生素的有效性，但缺乏现实证据。我们旨在评估年龄对强力霉素对AECOPD有效性的影响。使用大型药房配药数据库，对首次经口服糖皮质激素治疗的AECOPD的门诊患者进行了一项回顾性队列研究。主要结局是治疗开始后15-31天内的治疗失败。次要结果是第二次加重的时间。所有分析均按

尽管细菌对慢性阻塞性肺疾病（AECOPD）的急性加重有显着贡献，但抗生素的附加价值仍存在争议，尤其是在门诊患者中。年龄可能会影响抗生素的有效性，但缺乏现实证据。我们旨在评估年龄对强力霉素对AECOPD有效性的影响。

使用大型药房配药数据库，对首次经口服糖皮质激素治疗的AECOPD的门诊患者进行了一项回顾性队列研究。主要结局是治疗开始后15-31天内的治疗失败。次要结果是第二次加重的时间。所有分析均按年龄段分层。

研究共确定了6300名首例AECOPD患者。 2261名患者（36％）接受了强力霉素的治疗，4039名（64％）没有接受任何抗生素的治疗（对照组）。总体而言，两组的治疗失败率无差异（校正OR：0.97，95％CI：0.84至1.12）。同样，在年轻组中未观察到治疗失败的差异。但是，在高龄（≥75岁）患者中，强力霉素可显著降低治疗失败率（16％vs 20％，校正OR：0.77，95％CI：0.62至0.97）。总体而言，强力霉素组中至第二次加重的中位时间为169天（95％CI：158-182天），而对照组为180天（95％CI：169-191天）（校正后的HR：1.06，95％CI：0.99-1.12）。尽管在老年患者中，在3个月内有一种趋势，下一次强力霉素加重发作时间会更长，但并没有达到统计学意义。

综上所述，该研究结果表明，将强力霉素加到口服皮质类固醇激素中对短期老年慢性阻塞性肺疾病患者有短期治疗益处。对于目前在初级保健中的75岁以下的人来说，这个值仍然不清楚。无论年龄大小，都未观察到强力霉素对下一次加重的长期预防作用。

原始出处：

Wang Y, Bos JH, et al., Influence of age on real-life effects of doxycycline for acute exacerbations among COPD outpatients: a population-based cohort study. BMJ Open Respir Res. 2020 Feb;7(1). pii: e000535. doi: 10.1136/bmjresp-2019-000535.

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    2020-05-05 feather89

    #PE#

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    2020-08-16 gaoxiaoe

    #BMJ#

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    2020-08-21 楚秀娟

    #强力霉素#

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    2020-12-30 marongnuan

    #门诊患者#

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    2020-03-07 minzju5052

    #急性加重#

    0