本文選題：替加環(huán)素 + 亞胺培南/西司他汀　； 參考：《中國醫(yī)院藥學(xué)雜志》2017年24期

【摘要】：目的:系統(tǒng)評價替加環(huán)素(TGC)與亞胺培南/西司他汀(IMI/CIS)相比治療復(fù)雜腹腔感染的有效性與安全性。方法:計算機檢索PubMed、EMbase、Medline、The Cochrane Library(2017年3期)、CBM、CNKI、VIP和WanFang Data,同時檢索中國臨床試驗注冊中心(www.chictr.org.cn),檢索時間均從建庫至2017年3月。納入關(guān)于替加環(huán)素對比亞胺培南西司他汀治療復(fù)雜腹腔感染的隨機對照試驗(RCT)。采用RevMan 5.3統(tǒng)計軟件進行Meta分析。結(jié)果:共納入5項RCT,共計4 185例患者。Meta分析結(jié)果顯示:臨床治愈率:(1)ME人群:TGC與IMI/CIS組相比[RR=1.00,95%CI(0.95,1.05),P=0.92]臨床治愈率差異不明顯,差異無統(tǒng)計學(xué)意義;(2)CE人群:TGC組相比IMI/CIS組[RR=0.99,95%CI(0.96,1.02),P=0.50]臨床治愈率差異不明顯,差異無統(tǒng)計學(xué)意義;(3)c-mlTT人群:TGC組相比IMI/CIS組[RR=0.97,95%CI(0.94,1.00),P=0.05]差異有統(tǒng)計學(xué)意義,IMI/CIS組稍高于TGC組。不良反應(yīng)發(fā)生率:TGC組相比IMI/CIS組會增加患者二次感染發(fā)生率[RR=1.75,95%CI(1.34,2.28),P≤0.000 1]、惡心發(fā)生率[RR=1.34,95%CI(1.08,1.65),P=0.008]、嘔吐發(fā)生率[RR=1.39,95%CI(1.19,1.63),P≤0.000 1],其他不良反應(yīng)發(fā)生率差異無統(tǒng)計學(xué)意義。死亡率:TGC組較IMI/CIS組死亡率稍高,但差異無統(tǒng)計學(xué)意義[RR=1.45,95%CI(0.94,2.22),P=0.09]。結(jié)論:TGC較IMI/CIS并不能顯著提高治療復(fù)雜腹腔感染的臨床療效,卻增加主要胃腸道不良反應(yīng)與二次感染的發(fā)生率。受納入研究質(zhì)量和數(shù)量限制,上述結(jié)論有待更多高質(zhì)量的RCT來驗證。
[Abstract]:Objective: to evaluate the efficacy and safety of tigicycline in the treatment of complicated abdominal infection compared with imipenem / cilastatin IMIP / CIS.Methods: the Cochrane Library was searched by computer. The search time was from the establishment of the Cochrane Library to March 2017. The Chinese Clinical trial Registration Center was also searched at www.chictr.org.cnn.Then, the retrieval time was from the construction of the database to March 2017.To participate in a randomized controlled trial of tegacycline versus imipenem cilastatin in the treatment of complex celiac infections.Meta analysis was carried out with RevMan 5.3 statistical software.Results: a total of 4 185 RCTs were included. Meta-analysis showed that there was no significant difference in the clinical cure rate between the IMI/CIS group and the IMI/CIS group.There was no significant difference in the clinical cure rate between the IMI/CIS group and the IMI/CIS group. There was no significant difference in the clinical cure rate between the two groups. There was no significant difference in the clinical cure rate between the two groups. There was no significant difference between the two groups compared with the IMI/CIS group [RRR0.9795 CI 0.94 1.00 P0. 05] there was a significant difference in the clinical cure rate between the two groups (RRR0.9795 CI0.941.00P0. 05). There was no significant difference in the clinical cure rate between the two groups (RRRR0.9795 CI0.941.00P0. 05). The difference between the two groups was higher than that in the TGC group (P < 0.05).The incidence of adverse reactions in the IMI/CIS group was higher than that in the IMI/CIS group. The incidence of secondary infection [RRN1.75-95 CIQ 1.34 2.28], the incidence of nausea [RRR1.3495CII 1.081.65P0.008], the incidence of vomiting [RR1.3995CI1.191.63C], there was no significant difference in the incidence of other adverse reactions (P 鈮，

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