UNASSIGNED: A stepwise multivariable regression analysis was conducted to identify variables that were independently associated with day 28 all-cause mortality (ACM), favorable clinical response at early follow-up (EFU), and favorable microbiologic response at end of treatment (EOT). The analysis accounted for the number of baseline infecting pathogens and in vitro susceptibility to randomized treatment.
UNASSIGNED: Vasopressor use, renal impairment, bacteremia at baseline, and Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II scores ≥15 were associated with a greater risk of day 28 ACM. A favorable clinical response at EFU was associated with normal renal function, an APACHE II score <15, no vasopressor use, and no bacteremia at baseline. At EOT, a favorable microbiologic response was associated with IMI/REL treatment, normal renal function, no vasopressor use, nonventilated pneumonia at baseline, intensive care unit admission at randomization, monomicrobial infections at baseline, and absence of Acinetobacter calcoaceticus-baumannii complex at baseline. These factors remained significant after accounting for polymicrobial infection and in vitro susceptibility to assigned treatment.
UNASSIGNED: This analysis, which accounted for baseline pathogen susceptibility, validated well-recognized patient- and disease-related factors as independent predictors of clinical outcomes. These results lend further support to the noninferiority of IMI/REL to piperacillin/tazobactam and suggests that pathogen eradication may be more likely with IMI/REL.
UNASSIGNED: NCT02493764.
■进行了逐步多元回归分析,以确定与第28天全因死亡率(ACM)独立相关的变量,早期随访(EFU)的良好临床反应,和治疗结束时良好的微生物反应(EOT)。分析考虑了基线感染病原体的数量和随机治疗的体外敏感性。
■血管加压药的使用,肾功能损害,基线菌血症,急性生理评估和慢性健康评估(APACHE)II评分≥15与第28天ACM的更大风险相关。EFU的良好临床反应与正常肾功能相关,APACHEII评分<15,没有使用血管升压药,基线无菌血症.在EOT,良好的微生物反应与IMI/REL治疗相关,肾功能正常,不使用血管加压药,基线时的非通气性肺炎,随机进入重症监护室,基线时的抗生素感染,基线时不存在钙乙酸不动杆菌-鲍曼不动杆菌复合物。在考虑到多微生物感染和体外对指定治疗的敏感性后,这些因素仍然很重要。
■此分析,这说明了基线病原体易感性,验证公认的患者和疾病相关因素作为临床结局的独立预测因子。这些结果进一步支持了IMI/REL对哌拉西林/他唑巴坦的非劣效性,并表明IMI/REL更有可能根除病原体。
■NCT02493764。