https://scholars.lib.ntu.edu.tw/handle/123456789/526901
標題: | Comparative treatment failure rates of respiratory fluoroquinolones or β-lactam + macrolide versus β-lactam alone in the treatment for community-Acquired pneumonia in adult outpatients: An analysis of a nationally representative claims database | 作者: | Lee M.-T.G. Lee S.-H. Chang S.-S. Chan Y.-L. Pang L. Hsu S.-M. CHIEN-CHANG LEE |
公開日期: | 2015 | 卷: | 94 | 期: | 39 | 起(迄)頁: | e1662 | 來源出版物: | Medicine (United States) | 摘要: | No comparative effectiveness study has been conducted for the following 3 antibiotics: respiratory uoroquinolone, b-lactam, and blactam + advanced macrolide. To gain insights into the real-world clinical effectiveness of these antibiotics for community-Acquired pneumonia in adult outpatients, our study investigated the treatment failure rates in 2 million representative participants from the National Health Informatics Project (NHIP) of Taiwan. A new-user cohort design was used to follow NHIP participants from January 2000 until December 2009. Treatment failure was defined by either one of the following events: a second antibiotic prescription, hospitalization due to CAP, an emergency department visit with a diagnosis of CAP, or 30-day nonaccident-related mortality. From 2006 to 2009, we identified 9256 newly diagnosed CAP outpatients, 1602 of whom were prescribed levofloxacin, 2100 were prescribed moxifloxacin, 5049 were prescribed β-lactam alone, and 505 were prescribed advanced macrolide +β-lactam. Compared with the β-lactam-based regimen, the propensity score-matched odds ratio for composite treatment failure was 0.81 (95% CI, 0.67-0.97) for moxifloxacin, 1.10 (95% CI, 0.90-1.35) for levofloxacin, and 0.95 (95% CI, 0.67-1.35) for macrolide +β-lactam. Moxifloxacin was associated with lower treatment failure rates compared with β-lactam alone, or levofloxacin in Taiwanese CAP outpatients. However, due to inherent limitations in our claims database, more randomized controlled trials are required before coming to a conclusion on which antibiotic is more effective for Taiwanese CAP outpatients. More population-based comparative effectiveness studies are also encouraged and should be considered as an integral piece of evidence in local CAP treatment guidelines. Copyright ? 2015 Wolters Kluwer Health, Inc. All rights reserved. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/526901 | ISSN: | 0025-7974 | DOI: | 10.1097/MD.0000000000001662 | SDG/關鍵字: | amoxicillin plus clavulanic acid; azithromycin; clarithromycin; levofloxacin; moxifloxacin; sultamicillin; antiinfective agent; beta lactam; macrolide; quinolone derivative; adolescent; adult; aged; antibiotic therapy; Article; child; clinical effectiveness; cohort analysis; community acquired pneumonia; comparative effectiveness; controlled study; drug treatment failure; emergency ward; female; hospitalization; human; major clinical study; male; outpatient; prescription; priority journal; randomized controlled trial; Taiwan; treatment duration; ambulatory care; community acquired infection; comparative study; factual database; insurance; middle aged; Pneumonia, Bacterial; treatment failure; Adult; Aged; Ambulatory Care; Anti-Bacterial Agents; beta-Lactams; Community-Acquired Infections; Databases, Factual; Female; Fluoroquinolones; Humans; Insurance Claim Review; Macrolides; Male; Middle Aged; Pneumonia, Bacterial; Taiwan; Treatment Failure |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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