目的:乳腺炎主要由革兰氏阳性菌引起,通常涉及β-内酰胺类抗生素和克林霉素的治疗。恶唑烷酮由于其药代动力学特征而在皮肤和软组织感染(STTI)的治疗中显示出良好的效果。我们的目的是描述接受恶唑烷酮治疗乳腺组织SSTI的患者的临床特征和结果。
方法:在2016年9月至2022年11月期间接受恶唑烷酮作为初始或挽救治疗的诊断为乳腺感染的患者的回顾性单中心研究。通过药房数据库确定患者。主要结果是临床治愈。
结果:29例患者接受恶唑烷酮治疗:27例接受利奈唑胺治疗,2例替地唑胺治疗。中位年龄为41岁(IQR31.0-56.5),28例患者为女性。10例患者(35%)有乳腺癌病史,3人(10%)患有免疫抑制疾病。在24个人(83%)中获得了微生物分离。主要分离是耐甲氧西林金黄色葡萄球菌(8,28%)和对甲氧西林敏感的金黄色葡萄球菌(7,24%)。24名患者(83%)接受恶唑烷酮作为抢救治疗,中位持续时间为14天(IQR10-17)。24例患者(83%)获得临床治愈,而4在中位15天后复发(IQR4-34)。一个人失去了后续行动。三名患者(10%)正在服用选择性5-羟色胺再摄取抑制剂,其中一人同时接受利奈唑胺治疗4天,无不良事件记录.在2/12个体中观察到治疗期间的细胞减少。恶唑烷酮允许11/13住院患者出院。
结论:恶唑烷酮可作为治疗乳腺感染的替代药物。
OBJECTIVE: Mastitis is mainly caused by Gram-positive bacteria and usually involves treatment with beta-lactam antibiotics and clindamycin.
Oxazolidinones show good results in the treatment of skin and soft tissue infections (SSTIs) due to its pharmacokinetic characteristics. We aimed to describe clinical characteristics and outcomes of patients who received
oxazolidinones for the treatment of SSTIs of the mammary tissue.
METHODS: Retrospective single-centre study of patients with a diagnosis of breast infection who received treatment with oxazolidinones as initial or salvage therapy between September 2016 and November 2022. Patients were identified through the pharmacy database. The primary outcome was clinical cure.
RESULTS: Twenty-nine patients received
oxazolidinones: 27 received linezolid and 2 tedizolid. Median age was 41 years (IQR 31.0-56.5) and 28 patients were female. Ten patients (35%) had a history of breast cancer, while three (10%) had an immunosuppressive condition. Microbiological isolation was obtained in 24 individuals (83%). Predominant isolations were methicillin-resistant Staphylococcus aureus (8, 28%) and methicillin-susceptible S. aureus (7, 24%). Twenty-four patients (83%) received
oxazolidinones as a salvage therapy, with a median duration of 14 days (IQR 10-17). Clinical cure was achieved in 24 patients (83%), while 4 relapsed after a median of 15 days (IQR 4-34). One was lost to follow-up. Three patients (10%) were taking selective serotonin reuptake inhibitors, and one of them concurrently received linezolid for 4 days with no adverse events recorded. Cytopenia during treatment was observed in 2/12 individuals.
Oxazolidinones allowed hospital discharge in 11/13 hospitalized patients.
CONCLUSIONS: Oxazolidinones could be considered as an alternative for treating breast infections.