Research Article
Volume 18 Issue 4 - 2022
Parenteral use of Fluoroquinolones Improves the Survival Outcome in Critical Non-HIV, Smear Positive Pulmonary Tuberculosis in Surin Hospital, Thailand: Propensity Score Matching Analysis
Passorn Sueyanyongsiri*
Department of Medicine, Surin Hospital, Affiliated Institutes of Suranaree University of Technology, Thailand
*Corresponding Author: Department of Medicine, Surin Hospital, Affiliated Institutes of Suranaree University of Technology, Thailand.
Received: June 27, 2021; Published: April 18, 2022




Abstract

Introduction: Pulmonary tuberculosis (TB) is a severe disease spreading all over the world, with high mortality, particularly in patients who require ventilators. According to the World Health Organization (WHO), TB patients are suggested to be treated by concentrated drugs for 2 months and the other 4 months continuously because it can increase high rate of recovery from TB. However, high mortality is still found in patients with severe TB. For this reason, there are several suggestions that TB patients with high severity should receive parenteral drugs due to uncertain absorption of drugs, particularly TB drugs, in critical patients. Therefore, this research aimed to study the factors of enteral regimen and parenteral regimen on the difference in the risk of death.

Methodology: This is an observational study with the control group. The data of the patients with smear positive TB from 2013 to 2020 was collected. For the analysis of the new inpatients of this group in Surin Hospital, death was found. The 2 groups of the patients were compared by enteral regimen and parenteral regimen. Sixty day survival was evaluated. The data analysis included sex, age 70 years or over, underlying disease, and severity. The analysis was divided into 2 parts, before and after p-score matching. T-test was used for continuous numbers while Fisher’s exact test and std. difference was used for clustered data. The statistic used to measure the difference in death was relative risk and hazard ratio, with 95% confidence interval. Cox regression analysis was used for statistical test.

Results: It was found that among all patients diagnosed from 2013 to 2020, 639 were with smear positive pulmonary TB. And when testing the receipt of regimens, it was found that the risk of death in the enteral regimen group increased (Risk ratio 0.817 times (95% confidence interval 0.50 - 1.33), p-value = 0.431; and with the risk of death (Hazard ratio = 1.44 times (95% confidence interval 0.78 - 2.65), p-value = 0.239 or 1.50times (95% confidence interval 0.83 - 2.71), stpm2 at degree of freedom = 3. No difference was found when comparing with the parenteral regimen group. However, when analyzing by matching patients with similar severity, 32 patients were obtained per group. And when testing the receipt of regimens, the risk was found in the enteral regimen group (Risk ratio 2.67 times (95% confidence interval 1.48 - 4.80), p-value < 0.001; and with the risk of death (Hazard ratio = 5.17 times (95% confidence interval 2.32 - 11.50), p-value < 0.001or 6.54 times (95% confidence interval 2.82 - 15.19). When comparing with the parenteral regimen group.

Conclusion: It can be concluded that parenteral regimen could help reduce 60day mortality in TB patients with high severity.

 

Keywords: Pulmonary Tuberculosis; Anti-Tuberculosis Drug; Critical Care

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Citation: Passorn Sueyanyongsiri. “Parenteral use of Fluoroquinolones Improves the Survival Outcome in Critical Non-HIV, Smear Positive Pulmonary Tuberculosis in Surin Hospital, Thailand: Propensity Score Matching Analysis”. EC Microbiology 18.5 (2022): 01-09.

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