Efficacy of broad-spectrum antibiotics plus nitroimidazoles for abdominal infections:a decade-long real-world cohort study
OBJECTIVE To explore the clinical efficacy of broad-spectrum antibiotics plus nitroimidazoles for abdominal infection.METHODS The relevant clinical data were retrospectively reviewed for patients with abdominal infection on broad-spectrum antibiotics(BSA)alone or broad-spectrum antibiotics plus nitroimidazole(NCBSA)at a single center from June 2010 to May 2020.One-to-one propensity score matching(PSM)was performed for adjusting the potential differences in age,gender,APACHE n score and SOFA score of two groups.Clinical effective rate,hospitalization stay and total hospitalization expense were compared between two groups.Meanwhile,subgroup efficacy was analyzed according to disease severity(APACHE n score)and whether or not abdominal surgery was performed.RESULTS A total of 149 propensity score-matched case pairs were included.No inter-group statistical difference existed in clinical effective rate(P=0.236).BSA group had shorter hospitalization stay(18 vs.27 day,P=0.001)and lower hospitalization expense(85 185.7 vs.187 898.3 yuan,P＜0.001).However,body temperature and procalcitonin(PCT)were higher in NCBSA group than those in BSA group(P=0.007,P=O.045)and C-reactive protein(CRP)and white blood cell(WBC)also were higher in NCBSA group.However,no significant inter-group dif-ferences existed(P=0.105,P=0.170).And more patients(92 vs.38)in NCBSA group underwent abdominal surgery.It implied that infection and clinical conditions were probably more severe in NCBSA group.Subgroup analysis revealed that severity of dis-ease and an onset of postoperative co-infection did not affect therapeutic effect of two groups(P＞0.05).CONCLUSION Clini-cal efficacy of broad-spectrum antibiotics plus nitroimidazoles for abdominal infection is similar to that of broad-spectrum antibiot-ics alone.And more clinical evidence is required for the necessity of combining nitroimidazoles in these conditions.
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