Pre-hospital antibiotic treatment and mortality caused by invasive meningococcal disease, adjusting for indication bias.
Data(s) |
17/12/2012
17/12/2012
03/04/2009
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Resumo |
Background: Mortality from invasive meningococcal disease (IMD) has remained stable over the last thirty years and it is unclear whether pre-hospital antibiotherapy actually produces a decrease in this mortality. Our aim was to examine whether pre-hospital oral antibiotherapy reduces mortality from IMD, adjusting for indication bias. Methods: A retrospective analysis was made of clinical reports of all patients (n = 848) diagnosed with IMD from 1995 to 2000 in Andalusia and the Canary Islands, Spain, and of the relationship between the use of pre-hospital oral antibiotherapy and mortality. Indication bias was controlled for by the propensity score technique, and a multivariate analysis was performed to determine the probability of each patient receiving antibiotics, according to the symptoms identified before admission. Data on in-hospital death, use of antibiotics and demographic variables were collected. A logistic regression analysis was then carried out, using death as the dependent variable, and prehospital antibiotic use, age, time from onset of symptoms to parenteral antibiotics and the propensity score as independent variables. Results: Data were recorded on 848 patients, 49 (5.72%) of whom died. Of the total number of patients, 226 had received oral antibiotics before admission, mainly betalactams during the previous 48 hours. After adjusting the association between the use of antibiotics and death for age, time between onset of symptoms and in-hospital antibiotic treatment, pre-hospital oral antibiotherapy remained a significant protective factor (Odds Ratio for death 0.37, 95% confidence interval 0.15–0.93). Conclusion: Pre-hospital oral antibiotherapy appears to reduce IMD mortality. FIS (00/0049-01/02/03), Junta de Andalucía (247/00) and, partially, the IRYSS network (G03/202). |
Identificador |
Perea-Milla E, Olalla J, Sánchez-Cantalejo E, Martos F, Matute-Cruz P, Carmona-López G, et al. Pre-hospital antibiotic treatment and mortality caused by invasive meningococcal disease, adjusting for indication bias. BMC Public Health; 9:95 1471-2458 (Online) http://hdl.handle.net/10668/717 19344518 10.1186/1471-2458-9-95 |
Idioma(s) |
en |
Publicador |
BioMed Central Ltd |
Relação |
BMC public health http://www.biomedcentral.com/1471-2458/9/95 |
Direitos |
Acceso abierto |
Palavras-Chave | #Administración Oral #Antibacterianos #Oportunidad Relativa #Infecciones Meningocócicas #Intervalos de Confianza #Modelos Logísticos #Estudios Retrospectivos #Neisseria meningitidis #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Administration Routes::Administration, Oral #Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents #Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Probability::Odds Ratio #Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Neisseriaceae Infections::Meningococcal Infections #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Confidence Intervals #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Logistic Models #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies #Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Aerobic Bacteria::Gram-Negative Aerobic Rods and Cocci::Neisseriaceae::Neisseria::Neisseria meningitidis #Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Epidemiologic Factors::Bias (Epidemiology)::Selection Bias #Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies |
Tipo |
info:eu-repo/semantics/article info:eu-repo/semantics/published Artículo |