Purpose: To assess the impact of targeted antibiotic therapy on clinical outcomes of patients with lower respiratory tract (LRT) infection with Corynebacterium striatum (C. striatum).
Methods: A new propensity score-inverse probability of treatment weighting (IPTW) cohort study was conducted by using 10-year data. The study included LRT infection patients with respiratory secretions cultured positive for C. striatum simultaneously. The primary outcome was all-cause hospital mortality; the secondary outcomes included hospital stay, ICU stay and ventilation time. The safety outcomes were drug-related serum creatinine (Cr) increase and thrombocytopenia.
Results: A total of 339 patients were included in the cohort, and 84 (24.78%) initiated vancomycin or linezolid therapy. In the new IPTW cohort, targeted antibiotic therapy did not improve all-cause hospital mortality (P =0.632), and the OR (95% CI) was 0.879 (0.519– 1.488). Moreover, targeted antibiotic therapy was not associated with hospital stay (P =0.415), ICU stay (P =0.945) or ventilation time (P =0.885). The side effects of drug-related higher serum Cr (P =0.044) and thrombocytopenic levels (P =0.038) cannot be ignored.
Conclusion: Clinical benefits by vancomycin or linezolid targeted against LRT infection with C. striatum were limited and with drug-related side effects. A prospectively designed study is needed to further confirm the results.
Keywords: Corynebacterium striatum , lower respiratory tract infection, vancomycin, linezolid, all-cause mortality