Obesity Is Not Associated with Antimicrobial Treatment Failure for Intra-Abdominal Infection
| Autor: | Christopher M. Watson, Puja M. Shah, Stephen W. Davies, Zachary C. Dietch, Brandy L. Edwards, Robert G. Sawyer, Christopher A. Guidry, Charles H. Cook, Reza Askari, Rhett N. Willis, Therese M. Duane, Nicholas Namias, Patrick J. O'Neill, Lena M. Napolitano, Daniel L. Dent |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
0301 basic medicine Microbiology (medical) medicine.medical_specialty Wilcoxon signed-rank test Surgical Infection Society Articles 030106 microbiology Logistic regression Drug Administration Schedule Body Mass Index law.invention 03 medical and health sciences symbols.namesake 0302 clinical medicine Anti-Infective Agents Randomized controlled trial Recurrence law Internal medicine medicine Humans Obesity Treatment Failure 030212 general & internal medicine Fisher's exact test Aged Peritoneal Infection business.industry Middle Aged medicine.disease Antimicrobial Surgery Infectious Diseases symbols Intraabdominal Infections Regression Analysis business Body mass index |
| Zdroj: | Surgical Infections. 17:412-421 |
| ISSN: | 1557-8674 1096-2964 |
| DOI: | 10.1089/sur.2015.213 |
| Popis: | Obesity and commonly associated comorbidities are known risk factors for the development of infections. However, the intensity and duration of antimicrobial treatment are rarely conditioned on body mass index (BMI). In particular, the influence of obesity on failure of antimicrobial treatment for intra-abdominal infection (IAI) remains unknown. We hypothesized that obesity is associated with recurrent infectious complications in patients treated for IAI.Five hundred eighteen patients randomized to treatment in the Surgical Infection Society Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial were evaluated. Patients were stratified by obese (BMI ≥30) versus non-obese (BMI≥30) status. Descriptive comparisons were performed using Chi-square test, Fisher exact test, or Wilcoxon rank-sum tests as appropriate. Multivariable logistic regression using a priori selected variables was performed to assess the independent association between obesity and treatment failure in patients with IAI.Overall, 198 (38.3%) of patients were obese (BMI ≥30) versus 319 (61.7%) who were non-obese. Mean antibiotic d and total hospital d were similar between both groups. Unadjusted outcomes of surgical site infection (9.1% vs. 6.9%, p = 0.36), recurrent intra-abdominal infection (16.2% vs. 13.8, p = 0.46), death (1.0% vs. 0.9%, p = 1.0), and a composite of all complications (25.3% vs. 19.8%, p = 0.14) were also similar between both groups. After controlling for appropriate demographics, comorbidities, severity of illness, treatment group, and duration of antimicrobial therapy, obesity was not independently associated with treatment failure (c-statistic: 0.64).Obesity is not associated with antimicrobial treatment failure among patients with IAI. These results suggest that obesity may not independently influence the need for longer duration of antimicrobial therapy in treatment of IAI versus non-obese patients. |
| Databáze: | OpenAIRE |
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