Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-01-09

AUTHORS

Ji Young Park, Taehoon Lee, Hongyeul Lee, Hyo-Jeong Lim, Jinwoo Lee, Jong Sun Park, Young-Jae Cho, Young Sik Park, Chang-Hoon Lee, Sang-Min Lee, Ho Il Yoon, Jae-Joon Yim, Chul-Gyu Yoo, Young Whan Kim, Sung Koo Han, Choon-Taek Lee, Jae Ho Lee

ABSTRACT

BackgroundThere have been few studies of pulmonary actinomycosis, which is an uncommon anaerobic infection. Consequently, the optimal therapeutic regimen, appropriate duration of treatment, long-term prognosis, and factors predicting prognosis are not well established.MethodsWe retrospectively reviewed the medical records of histopathologically confirmed cases of pulmonary actinomycosis seen between November 2003 and December 2012.ResultsThe study included 68 patients with a mean age of 58.4 ± 11.6 years. Of the 68, initial surgery was performed in 15 patients (22.1%), while the remaining 53 (77.9%) received antibiotic therapy initially. In the initial antibiotic group, 45/53 (84.9%) were cured without relapse (median antibiotic duration 5.3 months). 5/53 (9.4%) patients were refractory medically (median antibiotic duration 9.7 months), and 3/53 (5.7%) experienced a recurrence (median time to relapse 35.3 months). In the initial surgery group, 14/15 (93.3%) were cured and treatment failure occurred in one (6.7%). In the multivariate analysis, the absence of an antibiotic response at 1 month was the only independent factor associated with a poor treatment outcome, with an adjusted odds ratio of 49.2 (95% CI, 3.34–724.30). There was no significant difference in treatment outcome based on the size of the parenchymal lesion, comorbidities, whether intravenous antibiotics were used, antibiotic therapy duration, or whether the initial treatment was surgical.ConclusionsAntibiotic treatment with or without surgery was effective for treatment of pulmonary actinomycosis. Nevertheless, treatment failure or recurrence occurred in a considerable proportion of patients, especially those resistant to the initial antibiotic treatment. More... »

PAGES

10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1471-2334-14-10

DOI

http://dx.doi.org/10.1186/1471-2334-14-10

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1033691713

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24400792


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21 schema:description BackgroundThere have been few studies of pulmonary actinomycosis, which is an uncommon anaerobic infection. Consequently, the optimal therapeutic regimen, appropriate duration of treatment, long-term prognosis, and factors predicting prognosis are not well established.MethodsWe retrospectively reviewed the medical records of histopathologically confirmed cases of pulmonary actinomycosis seen between November 2003 and December 2012.ResultsThe study included 68 patients with a mean age of 58.4 ± 11.6 years. Of the 68, initial surgery was performed in 15 patients (22.1%), while the remaining 53 (77.9%) received antibiotic therapy initially. In the initial antibiotic group, 45/53 (84.9%) were cured without relapse (median antibiotic duration 5.3 months). 5/53 (9.4%) patients were refractory medically (median antibiotic duration 9.7 months), and 3/53 (5.7%) experienced a recurrence (median time to relapse 35.3 months). In the initial surgery group, 14/15 (93.3%) were cured and treatment failure occurred in one (6.7%). In the multivariate analysis, the absence of an antibiotic response at 1 month was the only independent factor associated with a poor treatment outcome, with an adjusted odds ratio of 49.2 (95% CI, 3.34–724.30). There was no significant difference in treatment outcome based on the size of the parenchymal lesion, comorbidities, whether intravenous antibiotics were used, antibiotic therapy duration, or whether the initial treatment was surgical.ConclusionsAntibiotic treatment with or without surgery was effective for treatment of pulmonary actinomycosis. Nevertheless, treatment failure or recurrence occurred in a considerable proportion of patients, especially those resistant to the initial antibiotic treatment.
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27 schema:keywords BackgroundThere
28 MethodsWe
29 absence
30 actinomycosis
31 adjusted odds ratio
32 age
33 anaerobic infections
34 analysis
35 antibiotic group
36 antibiotic response
37 antibiotic therapy
38 antibiotic therapy duration
39 antibiotic treatment
40 antibiotics
41 appropriate duration
42 cases
43 comorbidities
44 considerable proportion
45 differences
46 duration
47 factors
48 failure
49 group
50 independent factors
51 infection
52 initial antibiotic treatment
53 initial surgery
54 initial surgery group
55 initial treatment
56 intravenous antibiotics
57 lesions
58 long-term prognosis
59 mean age
60 medical records
61 months
62 multivariate analysis
63 odds ratio
64 only independent factor
65 optimal therapeutic regimen
66 outcomes
67 parenchymal lesions
68 patients
69 poor treatment outcomes
70 prognosis
71 prognostic factors
72 proportion
73 pulmonary actinomycosis
74 ratio
75 records
76 recurrence
77 regimen
78 relapse
79 response
80 significant differences
81 size
82 study
83 surgery
84 surgery group
85 therapeutic regimen
86 therapy
87 therapy duration
88 treatment
89 treatment failure
90 treatment outcomes
91 years
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