虚血性大腸炎患者に対する抗菌薬治療の不確かな効果．

The Uncertain Effect of Antimicrobial Therapy in the Treatment of Patients with Ischemic Colitis.

• Jae Gon Lee
• Jin Hwa Park
• Dong Soo Han
• Hang Lak Lee
• Chan Hyuk Park
• Chang Soo Eun

抄録

中等度または重度の虚血性大腸炎患者には抗菌薬治療が推奨されているが，その有益な効果は不明である。本研究では，虚血性大腸炎の治療における抗菌薬治療の役割を検討した．虚血性大腸炎の患者を 2004 年 1 月から 2019 年 6 月までの間にレトロスペクティブに同定した。抗生物質を投与された患者（抗生物質群）と投与されなかった患者（無投与群）の特徴と転帰を比較した。臨床アウトカムには、死亡、手術、30 日以内の再入院、絶食期間、入院期間が含まれた。解析されたのは186人の患者で、122人が抗生物質群、64人が非抗生物質群であった。死亡、手術、30日以内の再入院の複合アウトカムは抗生物質群で3.3％、非抗生物質群で3.1％であった（＞0.999）。絶食期間は両群間で有意差はなかった（日数中央値、4.0対4.0、＝0.253）。しかし、入院期間は抗生物質群の方が非抗生物質群よりも長かった（中央値日数、9.0日 vs. 7.0、＝0.043）。虚血性大腸炎患者では、抗生物質を投与された患者と投与されなかった患者との間で、30日以内の死亡、手術、再入院の発生率に統計学的に有意な差はなかった。

Although antimicrobial therapy is recommended for patients with moderate or severe ischemic colitis, its beneficial effects are unclear. In the present study, the role of antimicrobial therapy in the treatment of ischemic colitis was investigated. Patients with ischemic colitis were retrospectively identified between January 2004 and June 2019. The characteristics and outcomes of patients who received antibiotics (antibiotics group) and those who did not (no-antibiotics group) were compared. Clinical outcomes included death, surgery, and readmission within 30 days, fasting duration, and hospital stay. Data from 186 patients were analyzed; 122 patients were in the antibiotics group and 64 in the no-antibiotics group. Composite outcome of death, surgery, and readmission within 30 days occurred in 3.3% of patients in the antibiotics group and 3.1% of patients in the no-antibiotics group ( > 0.999). Fasting duration was not significantly different between the two groups (median days, 4.0 vs. 4.0, = 0.253). However, hospital stays were longer in the antibiotics group than in the no-antibiotics group (median days, 9.0 vs. 7.0, = 0.043). In patients with ischemic colitis, there was no statistically significant difference in the incidence of death, surgery, and readmission within 30 days between patients who received antibiotics and those who did not receive antibiotics.