| アブストラクト | OBJECTIVES: Ceftriaxone is widely used for hospitalized patients with community-acquired pneumonia, but its optimal dosage remains unclear. METHODS: We retrospectively identified patients diagnosed with pneumonia between July 2010 and March 2022 from the Diagnosis Procedure Combination inpatient database in Japan. They were categorized into those receiving 2 or 1 g/day of ceftriaxone within the first 2 days of hospitalization. The primary outcome was 30-day in-hospital mortality. The secondary outcomes included overall adverse events (composite of biliary tract infection, Clostridioides difficile infection and allergic reactions) and each adverse event. A subgroup analysis was conducted for patients requiring mechanical ventilation. Propensity-score overlap-weighting analysis was used for comparisons. RESULTS: Among the 471 694 eligible patients, 63.3% received 2 g/day and 36.7% received 1 g/day of ceftriaxone. Propensity-score analysis showed no significant difference in 30-day in-hospital mortality between the two groups [4.5% versus 4.6%; risk difference (RD), -0.1%; 95% confidence interval (CI), -0.3% to 0.1%; P = 0.219]. Overall adverse events were slightly higher in the 2 g/day group (1.9% versus 1.8%; RD, 0.1%; 95% CI, 0.0%-0.2%; P = 0.007), particularly the proportion of C. difficile infection. In the subgroup analysis of patients requiring mechanical ventilation, the 2 g/day regimen was associated with lower 30-day mortality (17.2% versus 20.4%; RD, -3.2%; 95% CI, -5.6% to -0.9%; P = 0.006). CONCLUSIONS: While a ceftriaxone dose exceeding 1 g/day may not be necessary for routine pneumonia treatment, a 2 g/day regimen may be considered for patients with severe pneumonia requiring mechanical ventilation. |
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| ジャーナル名 | The Journal of antimicrobial chemotherapy |
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| Pubmed追加日 | 2025/6/10 |
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| 投稿者 | Taniguchi, Jumpei; Aso, Shotaro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Graduate School of Medical and;Dental Sciences, Institute of Science Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40492536/ |
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