初始的抗生素選擇可能與弗尼爾氏壞疽之預後無關

張哲綱、林宗彥、歐建慧

國立成功大學醫學院附設醫院 泌尿科

Initial Antibiotics Choice may not be Associated with the Prognosis of Fournier’s Gangrene

Che-Kang Chang, Tsung-Yen Lin, and Chien-Hui Ou

Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan

Purpose: Fournier’s Gangrene can be fatal. However, as time goes by with the progression of medical environment, especially the medication, the mortality rate is decreasing nowadays. We tried to discover the association between the severity, treatment plan and prognosis. If the result concludes the first choice of antibiotic use for better prognosis, it may turn out to be the standard treatment for Fournier’s gangrene at least in our studying region.

Materials and Methods: We collected the total 100 patients from 1996 to 2018 in National Cheng Kung University Hospital and calculated their correlating data including simplified Fournier’s Gangrene Severity Index (SFGSI), admission days and the initial antibiotic choices before realization of pathogens.

Results: We found that the patient group with lower scoring on SFGSI which was treated with first-line of antibiotics have no shorter duration of hospitalization compared to the patient group with higher scoring on SFGSI which was treated with second-line or broad-spectrum antibiotics.

Conclusions: From our single-center study, the initial antibiotic choices and the severity of Fournier’s gangrene may have impact on our clinical practice. However, there is no absolutely the most correct answer for choosing the best antibiotics for better prognosis.