Better efficacy of triple antibiotics therapy for human brucellosis: A systematic review and meta-analysis.

IF 3.8 2区医学 Q1 Medicine

PLoS Neglected Tropical Diseases Pub Date : 2023-09-14 eCollection Date: 2023-09-01 DOI:10.1371/journal.pntd.0011590

Shanjun Huang, Hao Wang, Fande Li, Lanping Du, Wenqi Fan, Meifang Zhao, Hua Zhen, Yuke Yan, Menghan Lu, Xin Han, Zhuo Li, Mujinyan Li, Shuqi An, Xinyao Zhang, Qing Zhen, Tiejun Shui

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引用次数: 1

Abstract

Background: The treatment of brucellosis suffers from a high recurrence rate and drug resistance. Our study researched the differences in efficacy and side effects between triple antibiotics therapy and dual antibiotics therapy in the treatment of brucellosis through a systematic review and meta-analysis.

Methods: We searched 4 English electronic databases and 2 Chinese electronic databases for randomized controlled trials and cohort studies published through September 2022 on the use of triple antibiotics versus dual antibiotics in the treatment of brucellosis. Overall outcome indicators were therapeutic failure rate, relapse rate, overall therapeutic failure rate, and side effect rate. Relative risk (RR) and 95% confidence intervals (95% CIs) were used as summary statistics. A fixed-effects model was used to combine the overall effect sizes.

Results: The meta-analysis included 15 studies consisting of 11 randomized controlled trials and 4 cohort studies. Triple antibiotics showed better efficacy than dual antibiotics in a comparison of 3 overall outcome indicators (therapeutic failure rate (RR 0.42; 95% CI 0.30 to 0.59 heterogeneity P = 0.29, I2 = 15%), relapse rate (RR 0.29; 95% CI 0.18 to 0.45 heterogeneity P = 0.88, I2 = 0%), and overall therapeutic failure rate (RR 0.37; 95% CI 0.28 to 0.48 heterogeneity P = 0.35, I2 = 9%)). The incidence of side effects in patients with brucellosis treated with triple antibiotics was not significantly different from that in brucellosis patients treated with dual antibiotics (RR 0.85; 95% CI 0.67 to 1.06 heterogeneity P = 0.1, I2 = 35%). Sensitivity analyses showed robust results and Peter's test showed no publication bias. The results of subgroup analyses for the research type, drugs, and type of brucellosis were largely consistent with the overall outcome indicators, indicating the reliability and robustness of the overall results.

Conclusions: In the treatment of brucellosis, triple antibiotics have better efficacy than dual antibiotics and do not increase the incidence of side effects.

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三种抗生素治疗人类布鲁氏菌病的疗效：系统综述和荟萃分析。

背景：布鲁氏菌病的治疗具有很高的复发率和耐药性。我们的研究通过系统回顾和荟萃分析，研究了三种抗生素治疗和双抗生素治疗布鲁氏菌病的疗效和副作用的差异。方法：我们检索了截至2022年9月发表的4个英文电子数据库和2个中文电子数据库，用于随机对照试验和队列研究三种抗生素与双重抗生素治疗布鲁氏菌病。总体结果指标为治疗失败率、复发率、总体治疗失败率和副作用率。使用相对风险（RR）和95%置信区间（95%CI）作为汇总统计。使用固定效应模型来组合整体效应大小。结果：荟萃分析包括15项研究，包括11项随机对照试验和4项队列研究。在3个总体结果指标（治疗失败率（RR 0.42；95%CI 0.30至0.59异质性P=0.29，I2=15%）、复发率（RR 0.29；95%CI 0.18至0.45异质性P=0.88，I2=0%）和总体治疗失败率的比较中，三种抗生素显示出比双种抗生素更好的疗效（RR 0.37；95%CI 0.28至0.48异质性P=0.35，I2=9%）。三种抗生素治疗的布鲁氏菌病患者的副作用发生率与双重抗生素治疗的患者没有显著差异（RR 0.85；95%CI 0.67至1.06异质性P=0.1，I2=35%）。敏感性分析显示了稳健的结果，Peter的测试显示没有发表偏倚。布鲁氏菌病研究类型、药物和类型的亚组分析结果与总体结果指标基本一致，表明总体结果的可靠性和稳健性。结论：三联抗生素治疗布鲁氏菌病疗效优于双联抗生素，且不增加副作用的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PLoS Neglected Tropical Diseases Medicine-Infectious Diseases

CiteScore

7.40

自引率

10.50%

发文量

723

审稿时长

2-3 weeks

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).