title: Anti-anaerobic coverage is not necessary for Klebsiella pneumoniae liver abscess: a propensity score-matched cohort study.
abstract: Although most Klebsiella pneumoniae liver abscesses have been reported to be monomicrobial, clinical outcomes have not been compared between antimicrobial therapy with and without anti-anaerobic coverage. A propensity score-matched cohort study was conducted using the 731 cases of K. pneumoniae liver abscess. Clinical outcomes were compared between a group discontinuing anti-anaerobic agents after K. pneumoniae identification and a group continuing. A total of 170 cases were matched at a 1:1 ratio using their propensity to discontinue anti-anaerobic agents. The McNemar's test showed no difference in mortality rates (1.8% for discontinuation versus 2.3% for continuation; P = 1.00) or relapse (1.8% versus 2.9%; P = 0.73) between groups. Early discontinuation of anti-anaerobic agents had no association with treatment failure by means of the generalized estimating equation model (odds ratio 0.48; P = 0.14) and the Kaplan-Meier method (P = 0.85) in matched groups. Early discontinuation of anti-anaerobic agents does not affect the clinical outcomes of patients with K. pneumoniae liver abscess.
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun Ah
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: iddrchung@gmail.com.
authors.forename: Doo Ryeon
authors.initials: DR
authors.lastname: Chung
authors.affiliation: Division of Infectious Diseases, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
authors.forename: Joon-Sup
authors.initials: JS
authors.lastname: Yeom
authors.affiliation: Division of Infectious Diseases, Konkuk University Hospital, Seoul, Republic of Korea.
authors.forename: Hyun Kyun
authors.initials: HK
authors.lastname: Ki
authors.affiliation: Division of Infectious Diseases, Konkuk University Hospital, Seoul, Republic of Korea.
authors.forename: Hae Suk
authors.initials: HS
authors.lastname: Cheong
authors.affiliation: Division of Infectious Diseases, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
authors.forename: Jun Seong
authors.initials: JS
authors.lastname: Son
authors.affiliation: Division of Infectious Diseases, Kangdong Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Seo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Kyung Hee University Hospital, Seoul, Republic of Korea.
authors.forename: Soo-Youn
authors.initials: SY
authors.lastname: Moon
authors.affiliation: Division of Infectious Diseases, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors.forename: Seung Soon
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors.forename: Jeong-A
authors.initials: JA
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Kyung-Hwa
authors.initials: KH
authors.lastname: Park
authors.affiliation: Division of Infectious Diseases, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Seung-Ji
authors.initials: SJ
authors.lastname: Kang
authors.affiliation: Division of Infectious Diseases, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Sook-In
authors.initials: SI
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Shin-Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Hyun Ha
authors.initials: HH
authors.lastname: Chang
authors.affiliation: Division of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea.
authors.forename: Seong Yeol
authors.initials: SY
authors.lastname: Ryu
authors.affiliation: Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, Republic of Korea.
authors.forename: Ki Tae
authors.initials: KT
authors.lastname: Kwon
authors.affiliation: Division of Infectious Diseases, Inje University Busan Paik Hospital, Busan, Republic of Korea.
authors.forename: Chisook
authors.initials: C
authors.lastname: Moon
authors.affiliation: Division of Infectious Diseases, Samsung Changwon Hospital, Changwon, Republic of Korea.
authors.forename: Yu Mi
authors.initials: YM
authors.lastname: Wi
authors.affiliation: Division of Infectious Diseases, Jeju National University Hospital, Jeju, Republic of Korea.
authors.forename: Sang Taek
authors.initials: ST
authors.lastname: Heo
authors.affiliation: Division of Infectious Diseases, Sam Medical Hospital, Anyang, Republic of Korea.
authors.forename: Mi Kyong
authors.initials: MK
authors.lastname: Joung
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Cheol-In
authors.initials: CI
authors.lastname: Kang
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D007711:Klebsiella pneumoniae / Q000472:pathogenicity*; D046290:Liver Abscess, Pyogenic / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008795:Metronidazole / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole
keywords: Anaerobic bacteria; Klebsiella pneumoniae; Liver abscess; Treatment outcome