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Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis

BACKGROUND: There 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. METHODS: We retrospectively...

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Autores principales: Park, Ji Young, Lee, Taehoon, Lee, Hongyeul, Lim, Hyo-Jeong, Lee, Jinwoo, Park, Jong Sun, Cho, Young-Jae, Park, Young Sik, Lee, Chang-Hoon, Lee, Sang-Min, Yoon, Ho Il, Yim, Jae-Joon, Yoo, Chul-Gyu, Kim, Young Whan, Han, Sung Koo, Lee, Choon-Taek, Lee, Jae Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898383/
https://www.ncbi.nlm.nih.gov/pubmed/24400792
http://dx.doi.org/10.1186/1471-2334-14-10
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author Park, Ji Young
Lee, Taehoon
Lee, Hongyeul
Lim, Hyo-Jeong
Lee, Jinwoo
Park, Jong Sun
Cho, Young-Jae
Park, Young Sik
Lee, Chang-Hoon
Lee, Sang-Min
Yoon, Ho Il
Yim, Jae-Joon
Yoo, Chul-Gyu
Kim, Young Whan
Han, Sung Koo
Lee, Choon-Taek
Lee, Jae Ho
author_facet Park, Ji Young
Lee, Taehoon
Lee, Hongyeul
Lim, Hyo-Jeong
Lee, Jinwoo
Park, Jong Sun
Cho, Young-Jae
Park, Young Sik
Lee, Chang-Hoon
Lee, Sang-Min
Yoon, Ho Il
Yim, Jae-Joon
Yoo, Chul-Gyu
Kim, Young Whan
Han, Sung Koo
Lee, Choon-Taek
Lee, Jae Ho
author_sort Park, Ji Young
collection PubMed
description BACKGROUND: There 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. METHODS: We retrospectively reviewed the medical records of histopathologically confirmed cases of pulmonary actinomycosis seen between November 2003 and December 2012. RESULTS: The 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. CONCLUSIONS: Antibiotic 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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spelling pubmed-38983832014-01-23 Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis Park, Ji Young Lee, Taehoon Lee, Hongyeul Lim, Hyo-Jeong Lee, Jinwoo Park, Jong Sun Cho, Young-Jae Park, Young Sik Lee, Chang-Hoon Lee, Sang-Min Yoon, Ho Il Yim, Jae-Joon Yoo, Chul-Gyu Kim, Young Whan Han, Sung Koo Lee, Choon-Taek Lee, Jae Ho BMC Infect Dis Research Article BACKGROUND: There 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. METHODS: We retrospectively reviewed the medical records of histopathologically confirmed cases of pulmonary actinomycosis seen between November 2003 and December 2012. RESULTS: The 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. CONCLUSIONS: Antibiotic 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. BioMed Central 2014-01-09 /pmc/articles/PMC3898383/ /pubmed/24400792 http://dx.doi.org/10.1186/1471-2334-14-10 Text en Copyright © 2014 Park et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Park, Ji Young
Lee, Taehoon
Lee, Hongyeul
Lim, Hyo-Jeong
Lee, Jinwoo
Park, Jong Sun
Cho, Young-Jae
Park, Young Sik
Lee, Chang-Hoon
Lee, Sang-Min
Yoon, Ho Il
Yim, Jae-Joon
Yoo, Chul-Gyu
Kim, Young Whan
Han, Sung Koo
Lee, Choon-Taek
Lee, Jae Ho
Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis
title Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis
title_full Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis
title_fullStr Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis
title_full_unstemmed Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis
title_short Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis
title_sort multivariate analysis of prognostic factors in patients with pulmonary actinomycosis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898383/
https://www.ncbi.nlm.nih.gov/pubmed/24400792
http://dx.doi.org/10.1186/1471-2334-14-10
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