Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study

Abstract Although frequent chronic obstructive pulmonary disease (COPD) exacerbation has been associated with the isolation of Pseudomonas aeruginosa (PA) in sputum cultures, it remains unknown whether the empirical use of anti-pseudomonal antibiotics can improve outcomes in patients with frequent C...

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Autores principales:	Akihiro Shiroshita, Chisato Miyakoshi, Shunta Tsutsumi, Hiroshi Shiba, Chigusa Shirakawa, Kenya Sato, Shinya Matsushita, Yuya Kimura, Keisuke Tomii, Masahiro Ohgiya, Yuki Kataoka
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/72333421deff41d9953a3a71f019955f
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spelling	oai:doaj.org-article:72333421deff41d9953a3a71f019955f2021-12-02T18:37:08ZEffectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study10.1038/s41598-021-99640-y2045-2322https://doaj.org/article/72333421deff41d9953a3a71f019955f2021-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99640-yhttps://doaj.org/toc/2045-2322Abstract Although frequent chronic obstructive pulmonary disease (COPD) exacerbation has been associated with the isolation of Pseudomonas aeruginosa (PA) in sputum cultures, it remains unknown whether the empirical use of anti-pseudomonal antibiotics can improve outcomes in patients with frequent COPD exacerbations. This multicenter retrospective cohort study evaluated whether the empirical use of anti-pseudomonal antibiotics improves the length of the hospital stay in patients with recurrent COPD exacerbation (≥ 2 admissions from April 1, 2008 to July 31, 2020). For statistical analysis, a log-linked Gamma model was used. Parameters were estimated using a generalized estimating equation model with an exchangeable correlation structure accounting for repeated observations from a single patient. Covariates included age, body mass index, home oxygen therapy use, respiratory rate, heart rate, oxygen use on admission, mental status, systemic steroid use, activities of daily living, and the number of recurrences. Hospital-specific effects were specified as fixed effects. In total, 344 patients and 965 observations of recurrent COPD exacerbations were selected. Anti-pseudomonal antibiotics were used in 173 patients (18%). The estimated change in the length of the hospital stay between anti-pseudomonal and non-anti-pseudomonal antibiotics groups was 0.039 days [95% confidence interval; − 0.083, 0.162]. Anti-pseudomonal antibiotics could not shorten the length of the hospital stay.Akihiro ShiroshitaChisato MiyakoshiShunta TsutsumiHiroshi ShibaChigusa ShirakawaKenya SatoShinya MatsushitaYuya KimuraKeisuke TomiiMasahiro OhgiyaYuki KataokaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Akihiro Shiroshita Chisato Miyakoshi Shunta Tsutsumi Hiroshi Shiba Chigusa Shirakawa Kenya Sato Shinya Matsushita Yuya Kimura Keisuke Tomii Masahiro Ohgiya Yuki Kataoka Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study
description	Abstract Although frequent chronic obstructive pulmonary disease (COPD) exacerbation has been associated with the isolation of Pseudomonas aeruginosa (PA) in sputum cultures, it remains unknown whether the empirical use of anti-pseudomonal antibiotics can improve outcomes in patients with frequent COPD exacerbations. This multicenter retrospective cohort study evaluated whether the empirical use of anti-pseudomonal antibiotics improves the length of the hospital stay in patients with recurrent COPD exacerbation (≥ 2 admissions from April 1, 2008 to July 31, 2020). For statistical analysis, a log-linked Gamma model was used. Parameters were estimated using a generalized estimating equation model with an exchangeable correlation structure accounting for repeated observations from a single patient. Covariates included age, body mass index, home oxygen therapy use, respiratory rate, heart rate, oxygen use on admission, mental status, systemic steroid use, activities of daily living, and the number of recurrences. Hospital-specific effects were specified as fixed effects. In total, 344 patients and 965 observations of recurrent COPD exacerbations were selected. Anti-pseudomonal antibiotics were used in 173 patients (18%). The estimated change in the length of the hospital stay between anti-pseudomonal and non-anti-pseudomonal antibiotics groups was 0.039 days [95% confidence interval; − 0.083, 0.162]. Anti-pseudomonal antibiotics could not shorten the length of the hospital stay.
format	article
author	Akihiro Shiroshita Chisato Miyakoshi Shunta Tsutsumi Hiroshi Shiba Chigusa Shirakawa Kenya Sato Shinya Matsushita Yuya Kimura Keisuke Tomii Masahiro Ohgiya Yuki Kataoka
author_facet	Akihiro Shiroshita Chisato Miyakoshi Shunta Tsutsumi Hiroshi Shiba Chigusa Shirakawa Kenya Sato Shinya Matsushita Yuya Kimura Keisuke Tomii Masahiro Ohgiya Yuki Kataoka
author_sort	Akihiro Shiroshita
title	Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study
title_short	Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study
title_full	Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study
title_fullStr	Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study
title_full_unstemmed	Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study
title_sort	effectiveness of empirical anti-pseudomonal antibiotics for recurrent copd exacerbation: a multicenter retrospective cohort study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/72333421deff41d9953a3a71f019955f
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Effectiveness of empirical anti-pseudomonal antibiotics for recurrent COPD exacerbation: a multicenter retrospective cohort study

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