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首页> 外文期刊>Antimicrobial agents and chemotherapy. >A propensity score analysis shows that empirical treatment with linezolid does not increase the thirty-day mortality rate in patients with gram-negative bacteremia
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A propensity score analysis shows that empirical treatment with linezolid does not increase the thirty-day mortality rate in patients with gram-negative bacteremia

机译：倾向得分分析表明，使用克利奈德进行经验治疗不会增加革兰氏阴性菌血症患者的30天死亡率

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The role of linezolid in empirical therapy of suspected bacteremia remains unclear. The aim of this study was to evaluate the influence of empirical use of linezolid or glycopeptides in addition to other antibiotics on the 30-day mortality rates in patients with Gram-negative bacteremia. For this purpose, 1,126 patients with Gram-negative bacteremia in the Hospital Clinic of Barcelona from 2000 to 2012 were included in this study. In order to compare the mortality rates between patients who received linezolid or glycopeptides, the propensity scores on baseline variables were used to balance the treatment groups, and both propensity score matching and propensity-adjusted logistic regression were used to compare the 30-day mortality rates between the groups. The overall 30-day mortality rate was 16.0% during the study period. Sixty-eight patients received empirical treatment with linezolid, and 1,058 received glycopeptides. The propensity score matching included 64 patients in each treatment group. After matching, the mortality rates were 14.1% (9/64) in patients who received glycopeptides and 21.9% (14/64) in those who received linezolid, and a nonsignificant association between empirical linezolid treatment and mortality rate (odds ratio [OR], 1.63; 95% confidence interval [CI], 0.69 to 3.82; P = 0.275, McNemar's test) was found. This association remained nonsignificant when variables that remained unbalanced after matching were included in a conditional logistic regression model. Further, the stratified propensity score analysis did not show any significant relationship between empirical linezolid treatment and the mortality rate after adjustment by propensity score quintiles or other variables potentially associated with mortality. In conclusion, the propensity score analysis showed that empirical treatment with linezolid compared with that with glycopeptides was not associated with 30-day mortality rates in patients with Gram-negative bacteremia.
机译：利奈唑胺在可疑菌血症的经验治疗中的作用尚不清楚。这项研究的目的是评估经验性使用利奈唑胺或糖肽以及其他抗生素对革兰氏阴性菌血症患者30天死亡率的影响。为此目的，从2000年至2012年，巴塞罗那医院诊所的1126例革兰氏阴性菌血症患者被纳入本研究。为了比较接受利奈唑胺或糖肽治疗的患者的死亡率，基线变量的倾向得分用于平衡治疗组，倾向得分匹配和倾向调整的逻辑回归均用于比较30天死亡率组之间。在研究期间，总的30天死亡率为16.0％。 68名患者接受了利奈唑胺的经验治疗，1,058名患者接受了糖肽治疗。倾向得分匹配包括每个治疗组中的64名患者。匹配后，接受糖肽治疗的患者的死亡率为14.1％（9/64），接受利奈唑胺的患者为21.9％（14/64），经验利奈唑胺治疗与死亡率之间无显着相关性（几率[OR] ; 1.63; 95％置信区间[CI]：0.69至3.82; P = 0.275，McNemar检验）。当条件对数回归模型中包含匹配后仍不平衡的变量时，这种关联仍然不重要。此外，分层倾向得分分析未显示经验性利奈唑胺治疗与通过倾向得分五分位数或其他可能与死亡率相关的变量进行调整后的死亡率之间的任何显着关系。总之，倾向评分分析表明，与革兰氏阴性菌血症患者相比，利奈唑胺与糖肽相比的经验治疗与30天死亡率无关。

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