PDF(Pubmed)
Abstract：
Patients with vascular anomalies (VAs) who receive oral sirolimus may be at high risk of infectious complications. Antibiotic prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMZ) has been advocated. However, there have been few evidence-based analyses on this topic. This study assessed the effect of prophylactic TMP-SMZ on the incidence of infections in VA patients receiving sirolimus monotherapy.
A retrospective, multicenter chart review was performed on all VA patients receiving sirolimus treatment from August, 2013 to January, 2021.
Before January 2017, 112 patients were treated with sirolimus without antibiotic prophylaxis. In the subsequent period, 195 patients were treated with TMP-SMZ for at least 12 months during sirolimus therapy. The percentage of patients with at least one serious infection during the initial 12 months of sirolimus treatment did not differ between the groups (difference, 1.1%; 95% CI - 7.0-8.0%). We observed no difference in the incidence of individual infection or total adverse events between the groups. The rate of sirolimus discontinuation due to adverse events did not differ significantly between groups.
We demonstrated that prophylactic TMP-SMZ does not decrease the incidence of infection or improve tolerance in VA patients receiving sirolimus monotherapy.
A retrospective, multicenter chart review was performed on all VA patients receiving sirolimus treatment from August, 2013 to January, 2021.
Before January 2017, 112 patients were treated with sirolimus without antibiotic prophylaxis. In the subsequent period, 195 patients were treated with TMP-SMZ for at least 12 months during sirolimus therapy. The percentage of patients with at least one serious infection during the initial 12 months of sirolimus treatment did not differ between the groups (difference, 1.1%; 95% CI - 7.0-8.0%). We observed no difference in the incidence of individual infection or total adverse events between the groups. The rate of sirolimus discontinuation due to adverse events did not differ significantly between groups.
We demonstrated that prophylactic TMP-SMZ does not decrease the incidence of infection or improve tolerance in VA patients receiving sirolimus monotherapy.
摘要：
目的：接受口服西罗莫司的血管异常（VA）患者可能存在感染性并发症的高风险。已提倡使用甲氧苄啶-磺胺甲恶唑（TMP-SMZ）进行抗生素预防。然而,关于这个主题的证据分析很少。本研究评估了预防性TMP-SMZ对接受西罗莫司单药治疗的VA患者感染发生率的影响。
方法：回顾性研究，从8月开始对所有接受西罗莫司治疗的VA患者进行多中心图表审查，2013年1月,2021年。
结果：在2017年1月之前，112例患者接受了西罗莫司治疗，没有预防抗生素。在随后的时期，195名患者在西罗莫司治疗期间接受TMP-SMZ治疗至少12个月。在西罗莫司治疗的最初12个月中，至少有一次严重感染的患者百分比在两组之间没有差异（差异，1.1%；95%CI-7.0-8.0%）。我们观察到组间个体感染或总不良事件的发生率没有差异。由于不良事件导致的西罗莫司停药率在组间没有显著差异。
结论：我们证明预防性TMP-SMZ不会降低接受西罗莫司单药治疗的VA患者的感染发生率或改善耐受性。
方法：回顾性研究，从8月开始对所有接受西罗莫司治疗的VA患者进行多中心图表审查，2013年1月,2021年。
结果：在2017年1月之前，112例患者接受了西罗莫司治疗，没有预防抗生素。在随后的时期，195名患者在西罗莫司治疗期间接受TMP-SMZ治疗至少12个月。在西罗莫司治疗的最初12个月中，至少有一次严重感染的患者百分比在两组之间没有差异（差异，1.1%；95%CI-7.0-8.0%）。我们观察到组间个体感染或总不良事件的发生率没有差异。由于不良事件导致的西罗莫司停药率在组间没有显著差异。
结论：我们证明预防性TMP-SMZ不会降低接受西罗莫司单药治疗的VA患者的感染发生率或改善耐受性。
