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Empirical Treatment With Carbapenem vs Third-generation Cephalosporin for Treatment of Spontaneous Bacterial Peritonitis

DC FieldValueLanguage
dc.contributor.author박준용-
dc.contributor.author이재승-
dc.date.accessioned2021-05-26T16:51:38Z-
dc.date.available2021-05-26T16:51:38Z-
dc.date.issued2021-05-
dc.identifier.issn1542-3565-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/182867-
dc.description.abstractBackground & aims: Third-generation cephalosporins (TGCs) are recommended as first-line antibiotics for treatment of spontaneous bacterial peritonitis (SBP). However, antibiotics against multidrug-resistant organisms (such as carbapenems) might be necessary. We aimed to evaluate whether carbapenems are superior to TGC for treatment of SBP. Methods: We performed a retrospective study of 865 consecutive patients with a first presentation of SBP (275 culture positive; 103 with TGC-resistant bacterial infections) treated at 7 referral centers in Korea, from September 2013 through January 2018. The primary outcome was in-hospital mortality. We made all comparisons using data from patients whose baseline characteristics were balanced by inverse probability of treatment weighting. Results: Of patients who initially received empirical treatment with antibiotics, 95 (11.0%) received carbapenems and 655 (75.7%) received TGCs. Among the entire study cohort, there was no significant difference in in-hospital mortality between the carbapenem (25.8%) and TGC (25.3%) groups (adjusted odds ratio [aOR], 0.97; 95% CI, 0.85-1.11; P = .66). In the subgroup of patients with high chronic liver failure-sequential organ failure assessment (CLIF-SOFA) scores (score of 7 or greater, n = 314), carbapenem treatment was associated with lower in-hospital mortality (23.1%) than in the TGC group (38.8%) (aOR, 0.84; 95% CI, 0.75-0.94; P=.002). In contrast, among patients with lower CLIF-SOFA scores (n = 436), in-hospital mortality did not differ significantly between the carbapenem group (24.7%) and the TGC group (16.0%) (aOR, 1.06; 95% CI, 0.85-1.32; P = .58). Conclusions: For patients with a first presentation of SBP, empirical treatment with carbapenem does not reduce in-hospital mortality compared to treatment with TGCs. However, among critically ill patients (CLIF-SOFA scores ≥7), empirical carbapenem treatment was significantly associated with lower in-hospital mortality than TGCs.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherW.B. Saunders-
dc.relation.isPartOfCLINICAL GASTROENTEROLOGY AND HEPATOLOGY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleEmpirical Treatment With Carbapenem vs Third-generation Cephalosporin for Treatment of Spontaneous Bacterial Peritonitis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorSun Woong Kim-
dc.contributor.googleauthorJun Sik Yoon-
dc.contributor.googleauthorJunyong Park-
dc.contributor.googleauthorYong Jin Jung-
dc.contributor.googleauthorJae Seung Lee-
dc.contributor.googleauthorJisoo Song-
dc.contributor.googleauthorHan Ah Lee-
dc.contributor.googleauthorYeon Seok Seo-
dc.contributor.googleauthorMinjong Lee-
dc.contributor.googleauthorJin Myung Park-
dc.contributor.googleauthorDae Hee Choi-
dc.contributor.googleauthorMoon Young Kim-
dc.contributor.googleauthorSeong Hee Kang-
dc.contributor.googleauthorJin Mo Yang-
dc.contributor.googleauthorDo Seon Song-
dc.contributor.googleauthorSung Won Chung-
dc.contributor.googleauthorMinseok Albert Kim-
dc.contributor.googleauthorHee Joon Jang-
dc.contributor.googleauthorHyunwoo Oh-
dc.contributor.googleauthorCheol-Hyung Lee-
dc.contributor.googleauthorYun Bin Lee-
dc.contributor.googleauthorEun Ju Cho-
dc.contributor.googleauthorSu Jong Yu-
dc.contributor.googleauthorYoon Jun Kim-
dc.contributor.googleauthorJung-Hwan Yoon-
dc.contributor.googleauthorJeong-Hoon Lee-
dc.identifier.doi10.1016/j.cgh.2020.06.046-
dc.contributor.localIdA01675-
dc.contributor.localIdA05963-
dc.relation.journalcodeJ02981-
dc.identifier.eissn1542-7714-
dc.identifier.pmid32623007-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S1542356520309095-
dc.subject.keywordAscites-
dc.subject.keywordCirrhosis-
dc.subject.keywordRisk of Death-
dc.subject.keywordTherapy-
dc.contributor.alternativeNamePark, Jun Yong-
dc.contributor.affiliatedAuthor박준용-
dc.contributor.affiliatedAuthor이재승-
dc.citation.volume19-
dc.citation.number5-
dc.citation.startPage976-
dc.citation.endPage98600000-
dc.identifier.bibliographicCitationCLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol.19(5) : 976-98600000, 2021-05-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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