Association between prophylactic antibiotic use for transarterial chemoembolization and occurrence of liver abscess: a retrospective cohort study.

• Material Type: 博士論文
• Title: Association between prophylactic antibiotic use for transarterial chemoembolization and occurrence of liver abscess: a retrospective cohort study.
• Author/Editor: Yoshihara, Shingo; Yamana, Hayato; Akahane, Manabu; Kishimoto, Miwa; Nishioka, Yuichi; Noda, Tatsuya; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Kasahara, Kei; Imamura, Tomoaki
• Author Heading: Yoshihara, Shingo; Yamana, Hayato; Akahane, Manabu; Kishimoto, Miwa; Nishioka, Yuichi; Noda, Tatsuya; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Kasahara, Kei; Imamura, Tomoaki
• Publication, Distribution, etc.: Elsevier
• Publication Date: 2021-10
• Publication Date (W3CDTF): 2021-10
• Alternative Title: 経動脈的化学塞栓術における予防的抗菌薬と肝膿瘍発症の関連 : 後方視的コホート研究
• Periodical title: Clinical microbiology and infection
• No. or year of volume/issue: 27 10
• Volume: 27
• Issue: 10
• Pages: 1514.e5-1514.e10
• ISSN (Periodical Title): ISSN : 1198-743X
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2021-06-25
• Dissertation Number: 甲第794号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Liver abscess; Propensity score; Prophylactic antibiotics; Real-world data; Transarterial chemoembolization
• Target Audience: 一般
• Note (General): type:Thesis; Objectives: Clinical evidence on prophylactic antibiotics for transarterial chemoembolization (TACE) to prevent liver abscess is limited because liver abscess is a rare event. This study aimed to analyse the association between prophylactic antibiotic use for TACE and the occurrence of liver abscess after TACE. Methods: Using the nationwide Diagnosis Procedure Combination database in Japan, we retrospectively identified patients who underwent TACE for hepatic cancer between July 2010 and March 2017. The primary outcome was liver abscess requiring procedural intervention within 30 days of TACE. Secondary outcomes included 30-day in-hospital mortality and length of stay. Propensity score matching was performed to adjust for potential confounding factors and compare outcomes between patients with and without prophylactic antibiotics. Results: Among 167 544 eligible patients, 134 712 received antibiotics and 32 832 did not. In the matched cohort of 29 211 pairs, the proportion of patients with liver abscess requiring procedural intervention was significantly lower in the antibiotics group than in the no-antibiotics group (0.08% vs. 0.22%, p 0.001; relative risk (95% confidence interval), 0.35 (0.22-0.57); absolute risk reduction, 0.0014 (0.0008-0.0021); and number needed to treat, 696 (476-1223)). There was no significant difference in 30-day in-hospital mortality between the groups. The length of stay was longer in the antibiotics group than in the no-antibiotics group (median, 10 vs. 9 days, p < 0.001). Conclusions: Prophylactic antibiotic use in patients undergoing TACE was associated with a reduced occurrence of liver abscess requiring procedural intervention.; 博士（医学）・甲第794号・令和3年6月25日; Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.; identifier:Clinical microbiology and infection Vol.27 No.10 p.1514.e5-1514.e10 (2021 Oct); identifier:1198743X; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3940; identifier:Clinical microbiology and infection, 27(10): 1514.e5-1514.e10
• Source: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3940/1/01%e7%94%b2794%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3940/2/02%e7%94%b2794%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3940/3/03%e7%94%b2794%e6%9c%ac%e6%96%87.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3940/4/04%e7%94%b2794Suppl.01.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3940/5/05%e7%94%b2794Suppl.02.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1016/j.cmi.2021.01.014
• Periodical Title (NCID): AA11098239; https://ci.nii.ac.jp/ncid/AA11098239
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU