تعیین عوامل موثر بر پاسخ به درمان دارویی آبسه ریوی:مطالعه مورد شاهدی

  Lung abscess is a purulent and necrotizing infection of lung tissue which leads to cavitation(s). Despite appropriate treatment, it has yet a high mortality rate (20%). Impaired consciousness, oral cavity infections, diabete, cerebro-vascular accidents and alcoholism are some predisposing factors. This research identified different factors affecting on medical treatment response and designed a regression model to predict the outcome.   This retrospective study reviewed patients with lung abscess, admitted in Iran Medical College Hospitals, during 1991-2000. Out of 91 patients, 60 were cured by medical treatment but the others failed to response to it. We have compared risk factors in these two groups.   The average age was 47.9 years and male to female ratio was 2.7. There was significant statistical relation between failure in medical therapy and diabete (OR: 0.27, p: 0.04), empyema (OR: 7.25, P: 0.0001), pleural effusion (OR: 4.25, P: 0.002), fever (OR: 0.43, P: 0.05) and antibiotic change (OR: 5. 96, P: 0.0001). The best therapeutic regimen was penicillin G ( 100% recovery) and penicillin G accompanied with metronidazol or clindamycin (79% recovery).   Mortality and complication are related to antimicrobial regimen and hospital nursing. Patients with empyema, pleural effusion or antibiotic change have a poor prognosis whereas diabete or fever at admittance means a better prognosis.   Since lung abscess also contains anaerobes, the recommended regimen is penicillin G with metronidazol or clindamycin.