Efficacy of early administration of liposomal amphotericin B in patients with septic shock: A nationwide observational study
Liposomal amphotericin B (L-AMB), a broad spectrum anti-fungicidal drug, is often administered to treat invasive fungal infections (IFIs). However, the most suitable time to initiate treatment in septic shock patients with IFI is unknown. Patients with septic shock treated with L-AMB were identified...
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| Veröffentlicht in: | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 2021-10, Vol.27 (10), p.1471-1476 |
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| container_title | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy |
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| creator | Tashiro, Masato Takazono, Takahiro Ota, Yuki Wakamura, Tomotaro Takahashi, Akinori Sato, Kumiko Miyazaki, Taiga Obata, Yoko Nishino, Tomoya Izumikawa, Koichi |
| description | Liposomal amphotericin B (L-AMB), a broad spectrum anti-fungicidal drug, is often administered to treat invasive fungal infections (IFIs). However, the most suitable time to initiate treatment in septic shock patients with IFI is unknown.
Patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database and were stratified according to L-AMB treatment initiation either at septic shock onset (early L-AMB group) or after the onset (delayed L-AMB group) to determine their survival rates following septic shock onset and the shock cessation period.
We identified 141 patients administered L-AMB on the day of or after septic shock onset: 60 patients received early treatment, whereas 81 patients received delayed treatment. Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P = 0.197; 6 weeks: 62.2% vs 44.5%, P = 0.061; 12 weeks: 43.4% vs 35.0%, P = 0.168, respectively). The septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0 ± 7.0 days vs 16.5 ± 15.4 days, P |
| doi_str_mv | 10.1016/j.jiac.2021.06.013 |
| format | Article |
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Patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database and were stratified according to L-AMB treatment initiation either at septic shock onset (early L-AMB group) or after the onset (delayed L-AMB group) to determine their survival rates following septic shock onset and the shock cessation period.
We identified 141 patients administered L-AMB on the day of or after septic shock onset: 60 patients received early treatment, whereas 81 patients received delayed treatment. Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P = 0.197; 6 weeks: 62.2% vs 44.5%, P = 0.061; 12 weeks: 43.4% vs 35.0%, P = 0.168, respectively). The septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0 ± 7.0 days vs 16.5 ± 15.4 days, P < 0.001), with a significant difference confirmed after adjusting for confounding factors with propensity score matching (7.1 ± 7.2 days vs 16.7 ± 14.0 days, P = 0.001).
Early L-AMB administration at septic shock onset may be associated with early shock cessation.</description><identifier>ISSN: 1341-321X</identifier><identifier>EISSN: 1437-7780</identifier><identifier>DOI: 10.1016/j.jiac.2021.06.013</identifier><language>eng</language><publisher>Elsevier Ltd</publisher><subject>Early administration ; Liposomal amphotericin B ; Mortality ; Observational study ; Septic shock</subject><ispartof>Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy, 2021-10, Vol.27 (10), p.1471-1476</ispartof><rights>2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-48acfca13ab60f7fbb2e725c0939d4374b0183399fa54485f161d58589c41b413</citedby><cites>FETCH-LOGICAL-c445t-48acfca13ab60f7fbb2e725c0939d4374b0183399fa54485f161d58589c41b413</cites><orcidid>0000-0001-7609-7679 ; 0000-0002-0696-5386</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27926,27927</link.rule.ids></links><search><creatorcontrib>Tashiro, Masato</creatorcontrib><creatorcontrib>Takazono, Takahiro</creatorcontrib><creatorcontrib>Ota, Yuki</creatorcontrib><creatorcontrib>Wakamura, Tomotaro</creatorcontrib><creatorcontrib>Takahashi, Akinori</creatorcontrib><creatorcontrib>Sato, Kumiko</creatorcontrib><creatorcontrib>Miyazaki, Taiga</creatorcontrib><creatorcontrib>Obata, Yoko</creatorcontrib><creatorcontrib>Nishino, Tomoya</creatorcontrib><creatorcontrib>Izumikawa, Koichi</creatorcontrib><title>Efficacy of early administration of liposomal amphotericin B in patients with septic shock: A nationwide observational study</title><title>Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy</title><description>Liposomal amphotericin B (L-AMB), a broad spectrum anti-fungicidal drug, is often administered to treat invasive fungal infections (IFIs). However, the most suitable time to initiate treatment in septic shock patients with IFI is unknown.
Patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database and were stratified according to L-AMB treatment initiation either at septic shock onset (early L-AMB group) or after the onset (delayed L-AMB group) to determine their survival rates following septic shock onset and the shock cessation period.
We identified 141 patients administered L-AMB on the day of or after septic shock onset: 60 patients received early treatment, whereas 81 patients received delayed treatment. Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P = 0.197; 6 weeks: 62.2% vs 44.5%, P = 0.061; 12 weeks: 43.4% vs 35.0%, P = 0.168, respectively). The septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0 ± 7.0 days vs 16.5 ± 15.4 days, P < 0.001), with a significant difference confirmed after adjusting for confounding factors with propensity score matching (7.1 ± 7.2 days vs 16.7 ± 14.0 days, P = 0.001).
Early L-AMB administration at septic shock onset may be associated with early shock cessation.</description><subject>Early administration</subject><subject>Liposomal amphotericin B</subject><subject>Mortality</subject><subject>Observational study</subject><subject>Septic shock</subject><issn>1341-321X</issn><issn>1437-7780</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kM1LwzAYxoMoOKf_gKccvbQmTdIP8TJlfsDAi4K3kKYJy2ybmmQbBf94082zl_eL53ng_QFwjVGKEc5vN-nGCJlmKMMpylOEyQmYYUqKpChKdBpnQnFCMvx5Di683yCEC1aWM_Cz1NpIIUdoNVTCtSMUTWd644MTwdh-urdmsN52ooWiG9Y2KGek6eEDjGWIKtUHD_cmrKFXQzAS-rWVX3dwAftDxt40CtraK7c77DHIh20zXoIzLVqvrv76HHw8Ld8fX5LV2_Pr42KVSEpZSGgppJYCE1HnSBe6rjNVZEyiilRN_JHWCJeEVJUWjNKSaZzjhpWsrCTFNcVkDm6OuYOz31vlA--Ml6ptRa_s1vOM0ZxVBUIsSrOjVDrrvVOaD850wo0cIz6h5hs-oeYTao5yHlFH0_3RpOITO6Mc9zJCkaoxTsnAG2v-s_8Clp6Jhw</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Tashiro, Masato</creator><creator>Takazono, Takahiro</creator><creator>Ota, Yuki</creator><creator>Wakamura, Tomotaro</creator><creator>Takahashi, Akinori</creator><creator>Sato, Kumiko</creator><creator>Miyazaki, Taiga</creator><creator>Obata, Yoko</creator><creator>Nishino, Tomoya</creator><creator>Izumikawa, Koichi</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7609-7679</orcidid><orcidid>https://orcid.org/0000-0002-0696-5386</orcidid></search><sort><creationdate>20211001</creationdate><title>Efficacy of early administration of liposomal amphotericin B in patients with septic shock: A nationwide observational study</title><author>Tashiro, Masato ; Takazono, Takahiro ; Ota, Yuki ; Wakamura, Tomotaro ; Takahashi, Akinori ; Sato, Kumiko ; Miyazaki, Taiga ; Obata, Yoko ; Nishino, Tomoya ; Izumikawa, Koichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-48acfca13ab60f7fbb2e725c0939d4374b0183399fa54485f161d58589c41b413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Early administration</topic><topic>Liposomal amphotericin B</topic><topic>Mortality</topic><topic>Observational study</topic><topic>Septic shock</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tashiro, Masato</creatorcontrib><creatorcontrib>Takazono, Takahiro</creatorcontrib><creatorcontrib>Ota, Yuki</creatorcontrib><creatorcontrib>Wakamura, Tomotaro</creatorcontrib><creatorcontrib>Takahashi, Akinori</creatorcontrib><creatorcontrib>Sato, Kumiko</creatorcontrib><creatorcontrib>Miyazaki, Taiga</creatorcontrib><creatorcontrib>Obata, Yoko</creatorcontrib><creatorcontrib>Nishino, Tomoya</creatorcontrib><creatorcontrib>Izumikawa, Koichi</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tashiro, Masato</au><au>Takazono, Takahiro</au><au>Ota, Yuki</au><au>Wakamura, Tomotaro</au><au>Takahashi, Akinori</au><au>Sato, Kumiko</au><au>Miyazaki, Taiga</au><au>Obata, Yoko</au><au>Nishino, Tomoya</au><au>Izumikawa, Koichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of early administration of liposomal amphotericin B in patients with septic shock: A nationwide observational study</atitle><jtitle>Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy</jtitle><date>2021-10-01</date><risdate>2021</risdate><volume>27</volume><issue>10</issue><spage>1471</spage><epage>1476</epage><pages>1471-1476</pages><issn>1341-321X</issn><eissn>1437-7780</eissn><abstract>Liposomal amphotericin B (L-AMB), a broad spectrum anti-fungicidal drug, is often administered to treat invasive fungal infections (IFIs). However, the most suitable time to initiate treatment in septic shock patients with IFI is unknown.
Patients with septic shock treated with L-AMB were identified from the Japanese Diagnosis Procedure Combination national database and were stratified according to L-AMB treatment initiation either at septic shock onset (early L-AMB group) or after the onset (delayed L-AMB group) to determine their survival rates following septic shock onset and the shock cessation period.
We identified 141 patients administered L-AMB on the day of or after septic shock onset: 60 patients received early treatment, whereas 81 patients received delayed treatment. Survival rates after septic shock onset were higher in the early L-AMB group than in the delayed L-AMB group (4 weeks: 68.4% vs 57.9%, P = 0.197; 6 weeks: 62.2% vs 44.5%, P = 0.061; 12 weeks: 43.4% vs 35.0%, P = 0.168, respectively). The septic shock cessation period was shorter in the early L-AMB group than in the delayed L-AMB group (7.0 ± 7.0 days vs 16.5 ± 15.4 days, P < 0.001), with a significant difference confirmed after adjusting for confounding factors with propensity score matching (7.1 ± 7.2 days vs 16.7 ± 14.0 days, P = 0.001).
Early L-AMB administration at septic shock onset may be associated with early shock cessation.</abstract><pub>Elsevier Ltd</pub><doi>10.1016/j.jiac.2021.06.013</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0001-7609-7679</orcidid><orcidid>https://orcid.org/0000-0002-0696-5386</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Early administration Liposomal amphotericin B Mortality Observational study Septic shock |
| title | Efficacy of early administration of liposomal amphotericin B in patients with septic shock: A nationwide observational study |
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