Is fluoroquinolone monotherapy a useful alternative treatment for Pseudomonas aeruginosa bacteraemia?

Is fluoroquinolone monotherapy a useful alternative treatment for Pseudomonas aeruginosa... Purpose Pseudomonas aeruginosa bacteraemia is associated with high mortality, and most monotherapies are beta-lactam- based. We aimed to investigate clinical outcomes of den fi itive u fl oroquinolone monotherapy versus beta-lactam monotherapy for P. aeruginosa bacteraemia. Methods This retrospective study enrolled adult patients receiving definitive monotherapy with beta-lactam or fluoroqui - nolone between November 2013 and November 2014 at Taipei Veterans General Hospital. The independent risk factors for 28-day mortality were analyzed by logistic regression and propensity score-adjusted analysis. Results Among the 105 patients enrolled, 78 patients received beta-lactams and 27 received fluoroquinolones (20 with ciprofloxacin and 7 with levofloxacin). Primary bacteraemia (39.0%) and urinary tract infections (37.1%) were the most common sources of bacteraemia. The 28-day mortality rate was 11.1% for those receiving fluoroquinolones and 32.1% for those receiving beta-lactams (P = 0.062). The 28-day mortality rate between the two groups stratified by APACHE II and Pitt bacteraemia scores showed no significant differences in each category. Propensity score-adjusted multivariate analysis revealed that definitive therapy with a fluoroquinolone was not associated with 28-day mortality (OR 0.42; 95% CI 0.08–2.23; P = 0.305). Conclusions Fluoroquinolone might be an alternative to beta-lactam as a definitive monotherapy for P. aeruginosa bac- teraemia http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Infection Springer Journals

Is fluoroquinolone monotherapy a useful alternative treatment for Pseudomonas aeruginosa bacteraemia?

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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer-Verlag GmbH Germany, part of Springer Nature
Subject
Medicine & Public Health; Infectious Diseases; General Practice / Family Medicine; Internal Medicine
ISSN
0300-8126
eISSN
1439-0973
D.O.I.
10.1007/s15010-018-1131-7
Publisher site
See Article on Publisher Site

Abstract

Purpose Pseudomonas aeruginosa bacteraemia is associated with high mortality, and most monotherapies are beta-lactam- based. We aimed to investigate clinical outcomes of den fi itive u fl oroquinolone monotherapy versus beta-lactam monotherapy for P. aeruginosa bacteraemia. Methods This retrospective study enrolled adult patients receiving definitive monotherapy with beta-lactam or fluoroqui - nolone between November 2013 and November 2014 at Taipei Veterans General Hospital. The independent risk factors for 28-day mortality were analyzed by logistic regression and propensity score-adjusted analysis. Results Among the 105 patients enrolled, 78 patients received beta-lactams and 27 received fluoroquinolones (20 with ciprofloxacin and 7 with levofloxacin). Primary bacteraemia (39.0%) and urinary tract infections (37.1%) were the most common sources of bacteraemia. The 28-day mortality rate was 11.1% for those receiving fluoroquinolones and 32.1% for those receiving beta-lactams (P = 0.062). The 28-day mortality rate between the two groups stratified by APACHE II and Pitt bacteraemia scores showed no significant differences in each category. Propensity score-adjusted multivariate analysis revealed that definitive therapy with a fluoroquinolone was not associated with 28-day mortality (OR 0.42; 95% CI 0.08–2.23; P = 0.305). Conclusions Fluoroquinolone might be an alternative to beta-lactam as a definitive monotherapy for P. aeruginosa bac- teraemia

Journal

InfectionSpringer Journals

Published: Mar 20, 2018

References

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