https://scholars.lib.ntu.edu.tw/handle/123456789/589285
標題: | Treatment outcomes in patients receiving conventional amphotericin B therapy: A prospective multicentre study in Taiwan | 作者: | Chen, Chien-Yuan Kumar R.N. Feng Y.-H. Ho C.-H. You J.-Y. Liao C.-C. Tseng C.-H. Mavros P. Gerth W.C. YEE-CHUN CHEN |
公開日期: | 2006 | 卷: | 57 | 期: | 6 | 起(迄)頁: | 1181-1188 | 來源出版物: | Journal of Antimicrobial Chemotherapy | 摘要: | Objectives: To evaluate treatment outcomes and healthcare resource use with conventional amphotericin B therapy for invasive fungal infections (IFIs). Patients and methods: A prospective observational study in hospitalized adult patients receiving amphotericin B treatment was undertaken at four hospitals in Taiwan. Patients were observed from the start of therapy to hospital discharge. Results: A total of 108 patients (October 2000 to April 2002) were included in the study. Proven or probable IFIs as defined by the EORTC/ MSG criteria were the reasons for the initiation of amphotericin B in 35.2% of the sample. A total of 24.1% patients developed nephrotoxicity (NT) (defined as a 50% increase in the baseline serum creatinine and achieving a peak of at least 2.0 mg/dL). Treatment of proven/probable IFIs [odds ratio (OR) = 4.16, 95% confidence interval (CI) = 1.61-10.75] was a significant predictor of the development of NT. The in-hospital mortality rate was 38.0%. Proven/probable IFIs (OR = 6.93, 95% CI = 2.62-18.29) and the development of NT (OR = 3.68, 95% CI = 1.22-11.04) were independent predictors of in-hospital mortality. For patients alive at discharge, those with NT had a trend of longer hospital stay compared with patients who had not developed NT (mean, 49.3 ± 18.2 versus 29.3 ± 22.3 days, P = 0.069). For patients who died, those who had developed NT died sooner (15.5 ± 16.7 versus 33. 8 ± 26.9 days, P = 0.0004). Conclusions: NT was associated with accelerated mortality and increased hospital stay for patients who survived. Using amphotericin B carefully or the use of antifungal agents with less potential for NT might improve patient outcomes. ? 2006 Oxford University Press. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-33749186943&doi=10.1093%2fjac%2fdkl107&partnerID=40&md5=ca83515a0775172c6b7737be777e2c7d https://scholars.lib.ntu.edu.tw/handle/123456789/589285 |
ISSN: | 0305-7453 | DOI: | 10.1093/jac/dkl107 | SDG/關鍵字: | aminoglycoside antibiotic agent; amphotericin B; antineoplastic agent; contrast medium; creatinine; immunosuppressive agent; nonsteroid antiinflammatory agent; polypeptide antibiotic agent; amphotericin B; creatinine; abnormally high substrate concentration in blood; adult; aged; article; aspergillosis; candidiasis; clinical trial; confidence interval; controlled clinical trial; controlled study; creatinine blood level; cryptococcosis; drug fatality; drug megadose; female; hospital discharge; hospital patient; human; length of stay; major clinical study; male; mortality; multicenter study; mycosis; nephrotoxicity; observational study; prediction; prospective study; statistical significance; Taiwan; treatment outcome; blood; drug effect; kidney; middle aged; Adult; Aged; Amphotericin B; Creatinine; Female; Humans; Kidney; Length of Stay; Male; Middle Aged; Mycoses; Prospective Studies; Taiwan; Treatment Outcome |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。