Abstract：
OBJECTIVE: The effectiveness of monotherapy and combination therapy with quinolones and macrolides for treating Legionnaires\' disease remains uncertain; this study aimed to assess the comparative effectiveness of three treatment approaches.
METHODS: Using a nationwide inpatient database, we analyzed 3560 eligible patients hospitalized for Legionnaires\' disease between April 1, 2014, and March 31, 2021; patients were divided into combination therapy, quinolone monotherapy, and macrolide monotherapy groups according to the antibiotics administered within 2 days of admission. We compared in-hospital mortality, total hospitalization costs, and length of stay across these groups using multiple propensity score analysis with inverse probability of treatment weighting.
RESULTS: Of the 3560 patients, there were 564 (15.8%), 2221 (62.4%), and 775 (21.8%) patients in the combination therapy, quinolone monotherapy, and macrolide monotherapy groups, respectively. No significant differences were observed in in-hospital mortality between combination therapy and quinolone monotherapy groups, and between combination therapy and macrolide monotherapy groups. There were no significant differences in total hospitalization costs or length of stay among the three groups.
CONCLUSIONS: The study suggests that there may not be a significant advantage in using a combination of quinolones and macrolides over monotherapy for the treatment of Legionnaires\' disease. Given the potential for increased side effects, careful consideration is advised when choosing this combination therapy.
METHODS: Using a nationwide inpatient database, we analyzed 3560 eligible patients hospitalized for Legionnaires\' disease between April 1, 2014, and March 31, 2021; patients were divided into combination therapy, quinolone monotherapy, and macrolide monotherapy groups according to the antibiotics administered within 2 days of admission. We compared in-hospital mortality, total hospitalization costs, and length of stay across these groups using multiple propensity score analysis with inverse probability of treatment weighting.
RESULTS: Of the 3560 patients, there were 564 (15.8%), 2221 (62.4%), and 775 (21.8%) patients in the combination therapy, quinolone monotherapy, and macrolide monotherapy groups, respectively. No significant differences were observed in in-hospital mortality between combination therapy and quinolone monotherapy groups, and between combination therapy and macrolide monotherapy groups. There were no significant differences in total hospitalization costs or length of stay among the three groups.
CONCLUSIONS: The study suggests that there may not be a significant advantage in using a combination of quinolones and macrolides over monotherapy for the treatment of Legionnaires\' disease. Given the potential for increased side effects, careful consideration is advised when choosing this combination therapy.
摘要：
背景：喹诺酮类和大环内酯类单药治疗和联合治疗治疗军团病的有效性仍不确定；本研究旨在评估三种治疗方法的相对有效性。
方法：使用全国住院数据库，我们分析了2014年4月1日至2021年3月31日因军团病住院的3,560名合格患者;患者分为联合治疗,喹诺酮单药治疗，和大环内酯单药治疗组，根据入院后2天内给予的抗生素。我们比较了住院死亡率，总住院费用，以及这些组的住院时间，使用多重倾向评分分析和治疗权重的逆概率。
结果：在3,560名患者中，有564人(15.8%)，2221（62.4%），775名（21.8%）患者接受联合治疗，喹诺酮单药治疗，和大环内酯单药治疗组，分别。联合治疗组和喹诺酮单药治疗组的院内死亡率无显著差异。以及联合治疗和大环内酯单药治疗组之间。三组之间的总住院费用或住院时间没有显着差异。
结论：该研究表明，使用喹诺酮类和大环内酯类的组合治疗军团病可能没有明显优势。考虑到副作用增加的可能性，在选择这种联合疗法时，建议仔细考虑。
方法：使用全国住院数据库，我们分析了2014年4月1日至2021年3月31日因军团病住院的3,560名合格患者;患者分为联合治疗,喹诺酮单药治疗，和大环内酯单药治疗组，根据入院后2天内给予的抗生素。我们比较了住院死亡率，总住院费用，以及这些组的住院时间，使用多重倾向评分分析和治疗权重的逆概率。
结果：在3,560名患者中，有564人(15.8%)，2221（62.4%），775名（21.8%）患者接受联合治疗，喹诺酮单药治疗，和大环内酯单药治疗组，分别。联合治疗组和喹诺酮单药治疗组的院内死亡率无显著差异。以及联合治疗和大环内酯单药治疗组之间。三组之间的总住院费用或住院时间没有显着差异。
结论：该研究表明，使用喹诺酮类和大环内酯类的组合治疗军团病可能没有明显优势。考虑到副作用增加的可能性，在选择这种联合疗法时，建议仔细考虑。
