S E van Roeden1, D F M Reukers2, C H M van Jaarsveld2, L M Kampschreur3, I M Hoepelman1, P C Wever4, C P Bleeker-Rovers5, J J Oosterheert1. 1. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, CX Utrecht, The Netherlands. 2. Department of Primary and Community Care, Academic Collaborative Center AMPHI, Radboud University Medical Center, Geert Grooteplein Zuid 10, GA Nijmegen, The Netherlands. 3. Department of Internal Medicine and Infectious Diseases, Medical Center Leeuwarden, Henri Dunantweg 2, AD Leeuwarden, The Netherlands. 4. Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, Henri Dunantstraat 1, GZ 's-Hertogenbosch, The Netherlands. 5. Department of Internal Medicine and Infectious Diseases and Radboud Expert Center for Q fever, Radboud University Medical Center, Geert Grooteplein Zuid 10, GA Nijmegen, The Netherlands.
Abstract
BACKGROUND: Chronic Q fever is accompanied by high mortality and morbidity, and requires prolonged antibiotic treatment. Little is known on long-term quality of life (LQOL) in chronic Q fever patients treated with antibiotics. AIM: To identify patient and treatment-related factors associated with impaired LQOL in chronic Q fever patients treated with antibiotics, and to assess patients' perception on treatment. DESIGN: Cross-sectional study. METHODS: LQOL was assessed with a validated questionnaire from the Nijmegen Clinical Screening Instrument. Patients' perception on treatment was measured with three newly developed questions. RESULTS: We included 64 patients: LQOL was impaired in 55% (n = 35) after a median follow-up of 5 years. Median treatment duration was 27 months. In multivariable analysis, treatment duration was significantly associated with impaired LQOL (OR 1.07; 95%CI 1.02-1.12, P < 0.01 per month increase). Age, gender, number of antibiotic regimens, surgical intervention, complications, diagnostic classification, focus of infection or registration of side effects during treatment were not associated with impaired LQOL. After start of treatment, 17 patients (27%) perceived improvement of their condition. Disadvantages of treatment were experienced on a daily basis by 24 patients (69%) with impaired LQOL and 13 patients (46%) without impaired LQOL (P = 0.04). CONCLUSIONS: LQOL in chronic Q fever patients treated with antibiotics is impaired in more than half of patients 5 years after diagnosis. Antibiotic treatment duration was the only variable associated with impaired LQOL. The majority of patients experienced disadvantages on a daily basis, highlighting the high burden of disease and treatment.
BACKGROUND: Chronic Q fever is accompanied by high mortality and morbidity, and requires prolonged antibiotic treatment. Little is known on long-term quality of life (LQOL) in chronic Q fever patients treated with antibiotics. AIM: To identify patient and treatment-related factors associated with impaired LQOL in chronic Q fever patients treated with antibiotics, and to assess patients' perception on treatment. DESIGN: Cross-sectional study. METHODS: LQOL was assessed with a validated questionnaire from the Nijmegen Clinical Screening Instrument. Patients' perception on treatment was measured with three newly developed questions. RESULTS: We included 64 patients: LQOL was impaired in 55% (n = 35) after a median follow-up of 5 years. Median treatment duration was 27 months. In multivariable analysis, treatment duration was significantly associated with impaired LQOL (OR 1.07; 95%CI 1.02-1.12, P < 0.01 per month increase). Age, gender, number of antibiotic regimens, surgical intervention, complications, diagnostic classification, focus of infection or registration of side effects during treatment were not associated with impaired LQOL. After start of treatment, 17 patients (27%) perceived improvement of their condition. Disadvantages of treatment were experienced on a daily basis by 24 patients (69%) with impaired LQOL and 13 patients (46%) without impaired LQOL (P = 0.04). CONCLUSIONS: LQOL in chronic Q fever patients treated with antibiotics is impaired in more than half of patients 5 years after diagnosis. Antibiotic treatment duration was the only variable associated with impaired LQOL. The majority of patients experienced disadvantages on a daily basis, highlighting the high burden of disease and treatment.
Authors: Daphne F M Reukers; Cornelia H M van Jaarsveld; Reinier P Akkermans; Stephan P Keijmel; Gabriella Morroy; Adriana S G van Dam; Peter C Wever; Cornelia C H Wielders; Koos van der Velden; Joris A F van Loenhout; Jeannine L A Hautvast Journal: PLoS One Date: 2022-02-02 Impact factor: 3.240