https://scholars.lib.ntu.edu.tw/handle/123456789/536283
標題: | Klebsiella pneumoniae meningitis: Timing of antimicrobial therapy and prognosis | 作者: | CHI-TAI FANG YEE-CHUN CHEN SHAN-CHWEN CHANG Sau W.-Y. KWEN-TAY LUH |
公開日期: | 2000 | 出版社: | Oxford University Press | 卷: | 93 | 期: | 1 | 起(迄)頁: | 45-53 | 來源出版物: | QJM - Monthly Journal of the Association of Physicians | 摘要: | We analysed the clinical course of 30 adult patients with Klebsiella pneumoniae meningitis, 18 community-acquired and 12 hospital-acquired, to assess whether the timing of appropriate antimicrobial therapy had a major effect on prognosis. Of the 30 patients, 29 received appropriate antibiotics. The time from initial symptoms to the start of appropriate therapy, antibiotic resistance of K. pneumoniae isolates, underlying disease severity, diabetes mellitus, age, gender, and acquisition settings were all not significantly correlated with outcome. However, a Glasgow coma scale (GCS) score of 7 points or less at the start of appropriate antimicrobial therapy was a valid predictor of death or a permanent vegetative state (sensitivity 82%, specificity 93%, p = 0.005), even after adjusting for the effect of confounding variables by logistic regression. Timing of appropriate antimicrobial therapy, as defined by consciousness level but not by symptom duration, is a major determinant of survival and neurological outcome for patients with K. pneumoniae meningitis, and the first dose of an appropriate antibiotic should be administrated before their consciousness deteriorates to a GCS score of 7 points or less. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0033954249&doi=10.1093%2fqjmed%2f93.1.45&partnerID=40&md5=05275d6028a85bf8b1dbf19677c0caa2 https://scholars.lib.ntu.edu.tw/handle/123456789/536283 |
ISSN: | 0033-5622 | DOI: | 10.1093/qjmed/93.1.45 | SDG/關鍵字: | antibiotic agent; adolescent; adult; age; aged; antibiotic resistance; antimicrobial therapy; article; bacterial meningitis; clinical article; consciousness; diabetes mellitus; disease course; disease duration; disease severity; female; gender; Glasgow coma scale; human; Klebsiella pneumoniae; male; mortality; persistent vegetative state; prediction; priority journal; prognosis; regression analysis; survival; symptom; treatment outcome |
顯示於: | 醫學系 |
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