PT -期刊文章AU -韦伯,布兰登·j . AU -索伦森,杰夫AU -杰弗逊,Al非盟- Mecham伊恩AU -迪恩,纳森TI - community-onset肺炎广谱抗生素使用和不良结果:队列研究援助- 10.1183/13993003.00057 -2019 DP - 2019年7月01 TA -欧洲呼吸杂志》第六PG - 1900057 - 54 IP - 1 4099 - //www.qdcxjkg.com/content/54/1/1900057.short 4100 - //www.qdcxjkg.com/content/54/1/1900057.full所以欧元和J2019 7月01;54 AB -问题是广谱抗生素的使用与贫穷的结果调整混杂因素后community-onset肺炎?方法我们进行了回顾,观察性队列研究的1995名成人肺炎承认从四个我们医院急诊。我们使用多变量回归研究广谱抗生素在30天死亡率的影响,滞留时间、成本和Clostridioides固执的感染(CDI)。解决指示偏差,我们开发了一个倾向分数使用多级(个人提供者)执行治疗反概率加权广义线性混合模型(IPTW)的平均处理效应估计的治疗。我们还手动审查antibiotic-associated不良事件的样例死亡病例。结果39.7%的患者接受了广谱抗生素,但耐药病原体在只有3%恢复。广谱抗生素与死亡率增加有关的未加权的多变量模型(或3.8,95%可信区间2.5 - -5.9;术;0.001)和IPTW分析(或4.6,95%可信区间2.9 - -7.5;术中,0.001)。 Broad-spectrum antibiotic use by either analysis was also associated with longer hospital stay, greater cost and increased CDI. Healthcare-associated pneumonia was not associated with mortality independent of broad-spectrum antibiotic use. In manual review we identified antibiotic-associated events in 17.5% of mortality cases.Conclusion Broad-spectrum antibiotics appear to be associated with increased mortality and other poor outcomes in community-onset pneumonia.Despite propensity-based, weighted balancing including providers and adjustment for multiple patient-level confounders, broad-spectrum antibiotics appear to be associated with increased mortality and other poor outcomes in community-onset pneumonia http://bit.ly/2DafBax