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Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis

OBJECTIVE: This study aimed to assess whether the short-term use of macrolide antibiotics during hospitalization can reduce in-hospital all-cause mortality compared to non-macrolide treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: A propensity...

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Autores principales: Morasert, Thotsaporn, Kriengwattanakul, Orakarn, Kulalert, Prapasri
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482436/
https://www.ncbi.nlm.nih.gov/pubmed/36124296
http://dx.doi.org/10.2147/COPD.S373595
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author Morasert, Thotsaporn
Kriengwattanakul, Orakarn
Kulalert, Prapasri
author_facet Morasert, Thotsaporn
Kriengwattanakul, Orakarn
Kulalert, Prapasri
author_sort Morasert, Thotsaporn
collection PubMed
description OBJECTIVE: This study aimed to assess whether the short-term use of macrolide antibiotics during hospitalization can reduce in-hospital all-cause mortality compared to non-macrolide treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: A propensity score (PS) matching analysis was performed using retrospective data from the admission records of AECOPD patients in the medical general ward and medical intensive care unit of a tertiary care center between October 2015 and September 2018. The multivariable Cox proportional hazard model was performed to eliminate residual confounding after the PS analysis. RESULTS: The mortality rate was 11.1% of 1528 admissions in the PS matching cohort. Approximately 70% of patients had respiratory failure requiring intubation on initial admission, and 34% had pneumonia. Macrolide treatment significantly reduced in-hospital mortality among AECOPD patients (adjusted hazard ratio, 0.55; 95% confidence interval 0.32–0.96; P=0.034). Clarithromycin was the most commonly prescribed macrolide (80%). CONCLUSION: Macrolide antibiotics reduced in-hospital mortality in hospitalized AECOPD patients. The combination of antimicrobial and immunomodulatory effects of macrolide treatment could play an essential role.
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spelling pubmed-94824362022-09-18 Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis Morasert, Thotsaporn Kriengwattanakul, Orakarn Kulalert, Prapasri Int J Chron Obstruct Pulmon Dis Original Research OBJECTIVE: This study aimed to assess whether the short-term use of macrolide antibiotics during hospitalization can reduce in-hospital all-cause mortality compared to non-macrolide treatment in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: A propensity score (PS) matching analysis was performed using retrospective data from the admission records of AECOPD patients in the medical general ward and medical intensive care unit of a tertiary care center between October 2015 and September 2018. The multivariable Cox proportional hazard model was performed to eliminate residual confounding after the PS analysis. RESULTS: The mortality rate was 11.1% of 1528 admissions in the PS matching cohort. Approximately 70% of patients had respiratory failure requiring intubation on initial admission, and 34% had pneumonia. Macrolide treatment significantly reduced in-hospital mortality among AECOPD patients (adjusted hazard ratio, 0.55; 95% confidence interval 0.32–0.96; P=0.034). Clarithromycin was the most commonly prescribed macrolide (80%). CONCLUSION: Macrolide antibiotics reduced in-hospital mortality in hospitalized AECOPD patients. The combination of antimicrobial and immunomodulatory effects of macrolide treatment could play an essential role. Dove 2022-09-13 /pmc/articles/PMC9482436/ /pubmed/36124296 http://dx.doi.org/10.2147/COPD.S373595 Text en © 2022 Morasert et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Morasert, Thotsaporn
Kriengwattanakul, Orakarn
Kulalert, Prapasri
Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis
title Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis
title_full Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis
title_fullStr Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis
title_full_unstemmed Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis
title_short Effect of Macrolide Antibiotics on In-Hospital Mortality Among Acute Exacerbation of COPD Patients: A Propensity Score-Matched Analysis
title_sort effect of macrolide antibiotics on in-hospital mortality among acute exacerbation of copd patients: a propensity score-matched analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482436/
https://www.ncbi.nlm.nih.gov/pubmed/36124296
http://dx.doi.org/10.2147/COPD.S373595
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