| アブストラクト | BACKGROUND: The optimal timing of antibiotic administration in patients with a liver abscess undergoing liver aspiration or drainage is unknown. METHODS: This was a retrospective cohort study using the Diagnosis Procedure Combination database, a national inpatient database in Japan. RESULTS: A total of 34,424 patients who were emergently hospitalized due to liver abscess between July 2010 and March 2020 were included. Of these, 31,248 (90.8%) received antibiotics on the day of admission (early antibiotics group), and 3176 (9.2%) did not (delayed antibiotics group). Multivariable logistic regression analyses showed that in-hospital mortality of patients in the early antibiotics group was significantly lower than that in the delayed antibiotics group (odds ratio, 0.61; 95% confidence interval, 0.52-0.72; p <0.001). Patients in the early antibiotics group had a significantly lower proportion of clinical deterioration (odds ratio, 0.73; 95% confidence interval, 0.63-0.84; p <0.001) and shorter length of stay (adjusted difference, -5.2 days; 95% confidence interval, -6.2 to -4.1 days; p <0.001) than those in the delayed antibiotics group. CONCLUSIONS: Starting antibiotic treatment on the day of admission was associated with lower mortality, a lower proportion of clinical deterioration, and a shorter length of hospital stay. |
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| 投稿者 | Shinmoto, Keito; Ohbe, Hiroyuki; Nakajima, Mikio; Miyamoto, Yuki; Sasabuchi, Yusuke; Yasunaga, Hideo; Hiraoka, Eiji |
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| 組織名 | Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center,;3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.;Electronic address: hohbey@gmail.com.;Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan;;Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance;Service Development, 4-5, Minami-Osawa, Hachioji-shi, Tokyo, 192-0364, Japan.;Department of Emergency Medicine, Kyoto Prefectural University of Medicine, 465;Kajii-cho Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.;Data Science Center, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke,;Tochigi Prefecture, 3290498, Japan. |
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