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Multivariate analysis of prognostic factors in patients with pulmonary actinomycosis

Cited 19 time in Web of Science Cited 14 time in Scopus
Authors
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
Issue Date
2014-01-09
Publisher
BioMed Central
Citation
BMC Infectious Diseases, 14(1):10
Keywords
ActinomycosisAnti-bacterial agentsTreatment outcomePrognostic factorsPulmonary
Description
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.
Abstract
Abstract

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.
Language
English
URI
https://hdl.handle.net/10371/100451
DOI
https://doi.org/10.1186/1471-2334-14-10
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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