Antibiotic therapy for necrotizing fasciitis caused by Vibrio vulnificus: retrospective analysis of an 8 year period

doi:10.1093/jac/dkr476

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學系 > 期刊論文 > Item 310902500/17803

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/17803

Title:	Antibiotic therapy for necrotizing fasciitis caused by Vibrio vulnificus: retrospective analysis of an 8 year period
Authors:	Chen, Shiuan-Chih Lee, Yuan-Ti Tsai, Shih-Jei Chan, Khee-Siang Chao, Wai-Nang Wang, Po-Hui Lin, Ding-Bang Chen, Chun-Chieh Lee, Meng-Chih
Contributors:	醫學研究所
Keywords:	cephalosporins;fluoroquinolones;treatment effectiveness;mortality
Date:	2011-11-24
Issue Date:	2017-06-27T07:05:12Z (UTC)
ISSN:	0305-7453
Abstract:	Abstract Objectives To compare the effectiveness of a third-generation cephalosporin alone, a third-generation cephalosporin plus minocycline, and a fluoroquinolone in patients with necrotizing fasciitis (NF) caused by Vibrio vulnificus. Methods A retrospective review of case notes was performed for 89 patients who presented with NF caused by V. vulnificus and underwent surgical intervention within 24 h of admission between 2003 and 2010. Data on comorbidities, clinical manifestations, laboratory studies, treatments and outcomes were extracted for analysis. These patients were grouped according to the antimicrobials prescribed: those who received only a third-generation cephalosporin (Group 1; n = 18); a third-generation cephalosporin plus minocycline (Group 2; n = 49); or a fluoroquinolone with/without minocycline (Group 3; n = 22). Results The mean age of the 89 patients included in the study was 64.0 ± 12.0 years (range 33–89 years); 55% of the patients were male. There were no differences in age, sex or clinical characteristics among the three groups except that patients in Group 3 had a higher frequency of underlying chronic renal insufficiency than those in Groups 1 and 2 (P = 0.009). Groups 2 and 3 each had a significantly lower case fatality rate than Group 1 (61% in Group 1 versus 14% in Group 2, P = 0.0003; 61% in Group 1 versus 14% in Group 3, P = 0.0027), while no difference in case fatality rate was noted between Groups 2 and 3. Conclusions Our data suggested that, in addition to primary surgery, fluoroquinolones or third-generation cephalosporins plus minocycline are the best option for antibiotic treatment of NF caused by V. vulnificus.
URI:	https://doi.org/10.1093/jac/dkr476 https://ir.csmu.edu.tw:8080/ir/handle/310902500/17803
Relation:	Issue Cover Volume 67 Issue 2 February 2012
Appears in Collections:	[醫學系] 期刊論文

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