| アブストラクト | INTRODUCTION: Liposomal amphotericin B (L-AMB), a broad spectrum anti-fungicidal drug, is often administered to treat invasive fungal infections (IFIs). However, the most suitable time to initiate treatment in septic shock patients with IFI is unknown. METHODS: Patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database and were stratified according to L-AMB treatment initiation either at septic shock onset (early L-AMB group) or after the onset (delayed L-AMB group) to determine their survival rates following septic shock onset and the shock cessation period. RESULTS: We identified 141 patients administered L-AMB on the day of or after septic shock onset: 60 patients received early treatment, whereas 81 patients received delayed treatment. Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P = 0.197; 6 weeks: 62.2% vs 44.5%, P = 0.061; 12 weeks: 43.4% vs 35.0%, P = 0.168, respectively). The septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0 +/- 7.0 days vs 16.5 +/- 15.4 days, P < 0.001), with a significant difference confirmed after adjusting for confounding factors with propensity score matching (7.1 +/- 7.2 days vs 16.7 +/- 14.0 days, P = 0.001). CONCLUSION: Early L-AMB administration at septic shock onset may be associated with early shock cessation. |
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| 投稿者 | Tashiro, Masato; Takazono, Takahiro; Ota, Yuki; Wakamura, Tomotaro; Takahashi, Akinori; Sato, Kumiko; Miyazaki, Taiga; Obata, Yoko; Nishino, Tomoya; Izumikawa, Koichi |
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| 組織名 | Department of Infectious Diseases, Nagasaki University Graduate School of;Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan; Nagasaki;University Infection Control and Education Center, Nagasaki University Hospital,;1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. Electronic address:;mtashiro@nagasaki-u.ac.jp.;Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan; Department of;Respiratory Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki,;852-8501, Japan. Electronic address: takahiro-takazono@nagasaki-u.ac.jp.;Department of Nephrology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki,;852-8501, Japan. Electronic address: yukiota@hospital.sasebo.nagasaki.jp.;Medical Affairs Division, Sumitomo Dainippon Pharma Co., Ltd, 1-13-1 Kyobashi,;Chuo-ku, Tokyo, 104-8356, Japan. Electronic address:;tomotaro-wakamura@ds-pharma.co.jp.;Deloitte Tohmatsu Consulting LLC, Marunouchi Nijubashi Building, 3-2-3;Marunouchi, Chiyoda-ku, Tokyo, 100-8361, Japan. Electronic address:;akintakahashi@tohmatsu.co.jp.;kusato@tohmatsu.co.jp.;852-8501, Japan. Electronic address: taiga-m@nagasaki-u.ac.jp.;852-8501, Japan. Electronic address: yobata-ngs@umin.ac.jp.;852-8501, Japan. Electronic address: tnishino@nagasaki-u.ac.jp.;koizumik@nagasaki-u.ac.jp. |
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