In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort study
Aim Combination treatment with clindamycin is recommended in patients with invasive group A Streptococcus infection; however, whether the same treatment is effective in invasive group B Streptococcus and S. dysgalactiae subspecies equisimilis infections remains unknown. We aimed to investigate wheth...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Acute Medicine & Surgery |
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| Online Access: | https://doi.org/10.1002/ams2.634 |
| _version_ | 1819093993149956096 |
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| author | Shoichiro Hamada Mikio Nakajima Richard H. Kaszynski Ryosuke Kumazawa Hiroki Matui Kiyohide Fushimi Hideaki Goto Yoshihiro Yamaguchi Hideo Yasunaga |
| author_facet | Shoichiro Hamada Mikio Nakajima Richard H. Kaszynski Ryosuke Kumazawa Hiroki Matui Kiyohide Fushimi Hideaki Goto Yoshihiro Yamaguchi Hideo Yasunaga |
| author_sort | Shoichiro Hamada |
| collection | DOAJ |
| description | Aim Combination treatment with clindamycin is recommended in patients with invasive group A Streptococcus infection; however, whether the same treatment is effective in invasive group B Streptococcus and S. dysgalactiae subspecies equisimilis infections remains unknown. We aimed to investigate whether clindamycin added to standard of care therapy would be effective in patients with invasive non‐group A β‐hemolytic Streptococcus infections. Methods This was a nationwide retrospective cohort study using the Japanese Diagnosis Procedure Combination inpatient database focusing on the period between 2010 and 2018. We extracted data on patients diagnosed with sepsis due to non‐group A β‐hemolytic Streptococcus. One‐to‐four propensity score‐matching was undertaken to compare patients who were treated with clindamycin within 2 days of admission (clindamycin group) and those who did not (control group). The primary outcome was in‐hospital mortality. Results We identified 3754 eligible patients during the study period. The patients were divided into the clindamycin (n = 296) and control groups (n = 3458). After one‐to‐four propensity score matching, we compared 289 and 1156 patients with and without clindamycin, respectively. In‐hospital mortality did not significantly differ between the two groups (9.7% versus 10.3%; risk difference 0.3%; 95% confidence interval, –3.5% to 4.2%). Conclusions This nationwide database study showed that combination therapy involving the use of clindamycin was not associated with lower in‐hospital mortality in patients with invasive non‐group A β‐hemolytic Streptococcus. |
| first_indexed | 2024-12-21T23:20:20Z |
| format | Article |
| id | doaj.art-16cadee915444eb39c3bd3f225887c80 |
| institution | Directory Open Access Journal |
| issn | 2052-8817 |
| language | English |
| last_indexed | 2024-12-21T23:20:20Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acute Medicine & Surgery |
| spelling | doaj.art-16cadee915444eb39c3bd3f225887c802022-12-21T18:46:48ZengWileyAcute Medicine & Surgery2052-88172021-01-0181n/an/a10.1002/ams2.634In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort studyShoichiro Hamada0Mikio Nakajima1Richard H. Kaszynski2Ryosuke Kumazawa3Hiroki Matui4Kiyohide Fushimi5Hideaki Goto6Yoshihiro Yamaguchi7Hideo Yasunaga8Emergency and Critical Care Center Tokyo Metropolitan Hiroo Hospital TokyoJapanEmergency and Critical Care Center Tokyo Metropolitan Hiroo Hospital TokyoJapanEmergency and Critical Care Center Tokyo Metropolitan Hiroo Hospital TokyoJapanDepartment of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo TokyoJapanDepartment of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo TokyoJapanDepartment of Health Policy and Informatics Tokyo Medical and Dental University Graduate School of Medicine Tokyo JapanEmergency and Critical Care Center Tokyo Metropolitan Hiroo Hospital TokyoJapanDepartment of Trauma and Critical Care medicine School of Medicine Kyorin University TokyoJapanDepartment of Clinical Epidemiology and Health Economics School of Public Health The University of Tokyo TokyoJapanAim Combination treatment with clindamycin is recommended in patients with invasive group A Streptococcus infection; however, whether the same treatment is effective in invasive group B Streptococcus and S. dysgalactiae subspecies equisimilis infections remains unknown. We aimed to investigate whether clindamycin added to standard of care therapy would be effective in patients with invasive non‐group A β‐hemolytic Streptococcus infections. Methods This was a nationwide retrospective cohort study using the Japanese Diagnosis Procedure Combination inpatient database focusing on the period between 2010 and 2018. We extracted data on patients diagnosed with sepsis due to non‐group A β‐hemolytic Streptococcus. One‐to‐four propensity score‐matching was undertaken to compare patients who were treated with clindamycin within 2 days of admission (clindamycin group) and those who did not (control group). The primary outcome was in‐hospital mortality. Results We identified 3754 eligible patients during the study period. The patients were divided into the clindamycin (n = 296) and control groups (n = 3458). After one‐to‐four propensity score matching, we compared 289 and 1156 patients with and without clindamycin, respectively. In‐hospital mortality did not significantly differ between the two groups (9.7% versus 10.3%; risk difference 0.3%; 95% confidence interval, –3.5% to 4.2%). Conclusions This nationwide database study showed that combination therapy involving the use of clindamycin was not associated with lower in‐hospital mortality in patients with invasive non‐group A β‐hemolytic Streptococcus.https://doi.org/10.1002/ams2.634β‐Hemolytic Streptococcusclindamycininvasive Streptococcus infectionStreptococcus agalactiaeStreptococcus dysgalactiae subspecies equisimilis |
| spellingShingle | Shoichiro Hamada Mikio Nakajima Richard H. Kaszynski Ryosuke Kumazawa Hiroki Matui Kiyohide Fushimi Hideaki Goto Yoshihiro Yamaguchi Hideo Yasunaga In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort study Acute Medicine & Surgery β‐Hemolytic Streptococcus clindamycin invasive Streptococcus infection Streptococcus agalactiae Streptococcus dysgalactiae subspecies equisimilis |
| title | In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort study |
| title_full | In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort study |
| title_fullStr | In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort study |
| title_full_unstemmed | In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort study |
| title_short | In‐hospital mortality among patients with invasive non‐group A β‐hemolytic Streptococcus treated with clindamycin combination therapy: a nationwide cohort study |
| title_sort | in hospital mortality among patients with invasive non group a β hemolytic streptococcus treated with clindamycin combination therapy a nationwide cohort study |
| topic | β‐Hemolytic Streptococcus clindamycin invasive Streptococcus infection Streptococcus agalactiae Streptococcus dysgalactiae subspecies equisimilis |
| url | https://doi.org/10.1002/ams2.634 |
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