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 titleClinical microbiology and infection
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
DOIinfo:doi/10.1016/j.cmi.2021.01.014
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2022-03-06T04:54:00+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション