摘要
目的:系统评价达托霉素和利奈唑胺治疗耐万古霉素肠球菌血流感染的临床疗效及安全性。方法:计算机检索PubMed、The Cochrane Library、Embase、CNKI、维普、万方等数据库,检索时限为从建库至2019年10月。由两名评价者按照纳入标准与排除标准独立筛选文献、提取资料并使用NOS表评价纳入研究质量后,采用RevMan 5.3进行Meta分析。结果:共纳入队列研究18篇,包括4830例患者,其中达托霉素组2254例,利奈唑胺组2576例。Meta分析结果显示:(1)疗效方面:达托霉素和利奈唑胺的全因死亡率、30 d死亡率、临床治愈率、细菌清除率及复发率方面差异无统计学意义(P>0.05)。(2)安全性方面:达托霉素的血小板减少症发生率明显低于利奈唑胺[OR=0.58,95%CI(0.37,0.91),P=0.02],两者的肌酸激酶升高发生率差异无统计学意义(P>0.05)。结论:临床上达托霉素与利奈唑胺治疗耐万古霉素肠球菌血流感染的疗效相当,安全性上达托霉素优于利奈唑胺。
OBJECTIVE To systematically evaluate the clinical efficacy and safety of daptomycin and rizamide in the treatment of vancomycin-resistant enterococcal bloodstream infections.METHODS PubMed, The Cochrane Library, Embase, CNKI, VIP, Wanfang database and other literature databases were searched online from the establishment of the library to October 2019. Two evaluators independently screened the literature and extracted the data according to the inclusion criteria and exclusion criteria, the NOS table was used to evaluate the quality of the included studies. Meta-analysis was performed using RevMan 5.3 software.RESULTS A total of 18 cohort studies with 4 830 patients were retrieved, including 2 576 in the linezolid group and 2 254 in the daptomycin group. The results of Meta-analysis showed that:(1)efficacy: No statistically significant differences were found in all-cause mortality, 30-day mortality, clinical cure rate, bacterial clearance and relapse rate for daptomycin and linezolid(P>0.05).(2)safety: The thrombocytopenia incidence of daptomycin was significantly lower than linezolid[OR=0.58,95%CI(0.37,0.91),P=0.02]. There was no significant difference in incidence of creatine kinase elevation between the two groups(P>0.05).CONCLUSION Daptomycin is as effective as rifamazolamide in the treatment of vancomycin-resistant enterococcal bloodstream infection, and daptomycin is superior to rifamazolamide in safety.
作者
唐冰颖
王颖琳
王婧
赵泉
TANG Bing-ying;WANG Ying-lin;WANG Jing;ZHAO Quan(College of Pharmacy in Yantai University,Shandong Yantai 264003,China;Department of Pharmacy,Yantai Yuhuangding Hospital,Shandong Yantai 264000,China)
出处
《中国医院药学杂志》
CAS
北大核心
2020年第21期2260-2268,共9页
Chinese Journal of Hospital Pharmacy
