TY - JOUR T1 -肺炎治疗失败:抗生素治疗的影响和成本分析JF -欧洲呼吸杂志JO - Eur Respir J SP - 611 LP - 618 DO - 10.1183/09031936.00098411 VL - 39 IS - 3 AU - Ott, S.R. AU - Hauptmeier, B.M. AU - eren, C. AU - Lepper, P.M.AU - Nüesch, E. AU - Pletz, M.W. AU - Hecht, J. AU - Welte, T. AU - Bauer, T.T. Y1 - 2012/03/01 UR - //www.qdcxjkg.com/content/39/3/611.abstract N2 -本研究的目的是调查住院社区获得性肺炎(CAP)患者治疗失败(TF)与初始抗生素治疗和经济影响的关系。CAP患者被纳入两项开放的、前瞻性的多中心研究，评估住院治疗的直接费用。患者接受莫西沙星(MFX)或非标准化抗生素治疗。治疗72小时后抗生素治疗向拓宽抗生素谱的任何改变都被认为是TF。共纳入1236例患者(平均±标准差年龄69.6±16.8岁，691例(55.9%)男性)。197名(15.9%)受试者发生TF，并导致较长住院时间(15.4±7.3天vs 9.8±4.2天;P<0.001)和增加的中位治疗费用(2206欧元vs 1284欧元;术中,0.001)。596例(48.2%)患者接受了MFX治疗，TF较少(10.9% vs 20.6%; p<0.001). After controlling for confounders in multivariate analysis, adjusted risk of TF was clearly reduced in MFX as compared with β-lactam monotherapy (adjusted OR for MFX 0.43, 95% CI 0.27–0.68) and was more comparable with a β-lactam plus macrolide combination (BLM) (OR 0.68, 95% CI 0.38–1.21). In hospitalised CAP, TF is frequent and leads to prolonged hospital stay and increased treatment costs. Initial treatment with MFX or BLM is a possible strategy to prevent TF, and may thus reduce treatment costs. ER -