Yasuhito Suzuki , Kento Sato , Suguru Sato , Sumito Inoue , Yoko Shibata
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引用次数: 0
摘要
背景:尽管呼吸道感染是引发慢性阻塞性肺疾病(COPD)病情加重的重要因素,但抗生素对慢性阻塞性肺疾病加重患者的益处仍存在争议。有必要评估抗生素与安慰剂对此类患者的疗效和安全性:我们对治疗慢性阻塞性肺疾病加重的抗生素与安慰剂的随机对照试验进行了系统回顾和荟萃分析,并比较了接受抗生素治疗和接受安慰剂治疗的患者的治疗失败、死亡率和不良事件发生率:本次荟萃分析共纳入了六项研究。与安慰剂治疗患者相比,抗生素治疗患者治疗失败的频率明显较低(几率比 [OR] 0.50,95% 置信区间 [CI] 0.35-0.71,P = 0.0001)。两组患者在死亡率(OR 0.44,95% CI 0.05-3.76,p = 0.45)或不良事件发生频率(OR 1.05,95% CI 0.75-1.48,p = 0.78)方面无明显差异:在当前的系统综述和荟萃分析中,我们发现抗生素对慢性阻塞性肺病恶化患者的治疗效果优于安慰剂,这体现在较低的治疗失败率上。
Antibiotic treatment for patients with exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis
Background
Although respiratory tract infection is a significant factor that triggers exacerbation of chronic obstructive pulmonary disease (COPD), the benefit of antibiotics for patients with COPD exacerbation remains controversial. It is necessary to evaluate the efficacy and safety of antibiotics versus placebo in such patients.
Methods
We conducted a systematic review and meta-analysis of randomized controlled trials of antibiotics versus placebo for the treatment of COPD exacerbation, and compared the frequencies of treatment failure, mortality, and adverse events between patients treated with antibiotics and those treated with placebo.
Results
A total of six studies were included in this meta-analysis. The frequency of treatment failure was significantly lower in the antibiotic-treated patients compared to the placebo-treated patients (odds ratios [OR] 0.50, 95% confidence intervals [CI] 0.35–0.71, p = 0.0001). There was no significant difference between the two groups in mortality (OR 0.44, 95% CI 0.05–3.76, p = 0.45) or frequency of adverse events (OR 1.05, 95% CI 0.75–1.48, p = 0.78).
Conclusion
In the current systematic review and meta-analysis, we found that antibiotics were superior to placebo in patients with exacerbated COPD, as shown by the lower treatment failure rate.