PDF(Pubmed)
Abstract：
UNASSIGNED: Necrotizing soft tissue infections (NSTIs) are life-threatening infections. The aim of this study is to evaluate the safety of clindamycin plus vancomycin versus linezolid as empiric treatment of NSTIs.
UNASSIGNED: This was a retrospective, single-center, quasi-experimental study of patients admitted from 1 June 2018 to 30 June 2019 (preintervention) and 1 May 2020 to 15 October 2021 (postintervention). Patients who received surgical management within 24 hours of NSTI diagnosis and at least 1 dose of linezolid or clindamycin were included. The primary endpoint was death at 30 days. The secondary outcomes included rates of acute kidney injury (AKI) and Clostridioides difficile infection (CDI).
UNASSIGNED: A total of 274 patients were identified by admission diagnosis code for NSTI or Fournier gangrene; 164 patients met the inclusion criteria. Sixty-two matched pairs were evaluated. There was no difference in rates of 30-day mortality (8.06% vs 6.45%; hazard ratio [HR], 1.67 [95% confidence interval {CI}, .32-10.73]; P = .65). There was no difference in CDI (6.45% vs 1.61%; HR, Infinite [Inf], [95% CI, .66-Inf]; P = .07) but more AKI in the preintervention group (9.68% vs 1.61%; HR, 6 [95% CI, .73-276]; P = .05).
UNASSIGNED: In this small, retrospective, single-center, quasi-experimental study, there was no difference in 30-day mortality in patients receiving treatment with clindamycin plus vancomycin versus linezolid in combination with standard gram-negative and anaerobic therapy and surgical debridement for the treatment of NSTIs. A composite outcome of death, AKI, or CDI within 30 days was more common in the clindamycin plus vancomycin group.
UNASSIGNED: This was a retrospective, single-center, quasi-experimental study of patients admitted from 1 June 2018 to 30 June 2019 (preintervention) and 1 May 2020 to 15 October 2021 (postintervention). Patients who received surgical management within 24 hours of NSTI diagnosis and at least 1 dose of linezolid or clindamycin were included. The primary endpoint was death at 30 days. The secondary outcomes included rates of acute kidney injury (AKI) and Clostridioides difficile infection (CDI).
UNASSIGNED: A total of 274 patients were identified by admission diagnosis code for NSTI or Fournier gangrene; 164 patients met the inclusion criteria. Sixty-two matched pairs were evaluated. There was no difference in rates of 30-day mortality (8.06% vs 6.45%; hazard ratio [HR], 1.67 [95% confidence interval {CI}, .32-10.73]; P = .65). There was no difference in CDI (6.45% vs 1.61%; HR, Infinite [Inf], [95% CI, .66-Inf]; P = .07) but more AKI in the preintervention group (9.68% vs 1.61%; HR, 6 [95% CI, .73-276]; P = .05).
UNASSIGNED: In this small, retrospective, single-center, quasi-experimental study, there was no difference in 30-day mortality in patients receiving treatment with clindamycin plus vancomycin versus linezolid in combination with standard gram-negative and anaerobic therapy and surgical debridement for the treatment of NSTIs. A composite outcome of death, AKI, or CDI within 30 days was more common in the clindamycin plus vancomycin group.
摘要：
■坏死性软组织感染（NSTIs）是威胁生命的感染。这项研究的目的是评估克林霉素加万古霉素与利奈唑胺作为NSTIs经验性治疗的安全性。
■这是一个回顾，单中心,2018年6月1日至2019年6月30日（干预前）和2020年5月1日至2021年10月15日（干预后）收治的患者的准实验研究。包括在NSTI诊断后24小时内接受手术治疗和至少1剂利奈唑胺或克林霉素的患者。主要终点是30天的死亡。次要结局包括急性肾损伤（AKI）和艰难梭菌感染（CDI）的发生率。
■根据NSTI或Fournier坏疽的入院诊断代码确定了274例患者；164例患者符合纳入标准。评估了62对匹配的对。30天死亡率无差异(8.06%vs6.45%;危险比[HR],1.67[95%置信区间{CI}，.32-10.73]；P=.65）。CDI无差异（6.45%vs1.61%；HR，无限[Inf]，[95%CI，.66-Inf]；P=.07），但干预前组中AKI较多（9.68%vs1.61%；HR，6[95%CI，.73-276]；P=0.05）。
■在这个小的，回顾性,单中心,准实验研究,在接受克林霉素联合万古霉素治疗与利奈唑胺联合标准革兰阴性和厌氧治疗以及手术清创术治疗NSTIs的患者中,30日死亡率无差异.死亡的复合结果，AKI,或CDI在30天内更常见的克林霉素加万古霉素组。
■这是一个回顾，单中心,2018年6月1日至2019年6月30日（干预前）和2020年5月1日至2021年10月15日（干预后）收治的患者的准实验研究。包括在NSTI诊断后24小时内接受手术治疗和至少1剂利奈唑胺或克林霉素的患者。主要终点是30天的死亡。次要结局包括急性肾损伤（AKI）和艰难梭菌感染（CDI）的发生率。
■根据NSTI或Fournier坏疽的入院诊断代码确定了274例患者；164例患者符合纳入标准。评估了62对匹配的对。30天死亡率无差异(8.06%vs6.45%;危险比[HR],1.67[95%置信区间{CI}，.32-10.73]；P=.65）。CDI无差异（6.45%vs1.61%；HR，无限[Inf]，[95%CI，.66-Inf]；P=.07），但干预前组中AKI较多（9.68%vs1.61%；HR，6[95%CI，.73-276]；P=0.05）。
■在这个小的，回顾性,单中心,准实验研究,在接受克林霉素联合万古霉素治疗与利奈唑胺联合标准革兰阴性和厌氧治疗以及手术清创术治疗NSTIs的患者中,30日死亡率无差异.死亡的复合结果，AKI,或CDI在30天内更常见的克林霉素加万古霉素组。
