吸入式抗生素治疗肺炎的有效性和安全性:系统回顾与元分析》。

IF 3.3 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Zengzeng Zhang , Hong Li , Yutao Hu , Binhui Sun , Tingting Ke , Qihuan Wu , Xiang Lian , Wei Yu
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引用次数: 0

摘要

研究目的本研究旨在通过荟萃分析评估吸入式抗生素对成人肺炎患者的疗效和安全性:在 2024 年 5 月 31 日截止日期前,通过五个数据库(PubMed、Embase、Cochrane Library、Web of Science 和 Scopus)完成文献检索。研究选择和数据提取过程由两名审稿人独立完成。观察性研究和随机对照试验(RCT)研究的质量分别采用纽卡斯尔-渥太华量表和贾达德量表进行评估。主要结果包括死亡率、临床治愈率和微生物治愈率。次要结果为复发和肾功能损害:结果:共分析了 30 项研究,包括 12 项 RCT 研究和 18 项观察性研究。在 RCT 研究中,吸入抗生素并不能显著降低死亡率(几率比(OR)=1.06,95% 置信区间(CI):0.80-1.41)。吸入性抗生素与较高的临床治愈率(RCT 研究中 OR=1.47 95%CI:0.82-2.66;观察性研究中 OR=2.09,95%CI:1.36-3.21)和微生物治愈率(RCT 研究中 OR=7.00,观察性研究中 OR=2.20)相关。亚组分析显示,吸入抗生素联合静脉给药和吸入阿米卡星能更好地改善患者的死亡率、临床治愈率和微生物治愈率。吸入抗生素与复发无关。在RCT研究和观察性研究中,肾功能损害的汇总OR值分别为0.65(95%CI:0.27-1.13;I-squared=43.5%,P=0.124)和0.63(95%CI:0.26-1.11;I-squared=69.0%,P=0.110):结论:吸入抗生素可降低肾功能损害的风险,并显著改善肺炎患者的临床和微生物治愈率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The efficacy and safety of inhaled antibiotics for pneumonia: A systematic review and meta-analysis

Objectives

The aim of this study was to evaluate the efficacy and safety of inhaled antibiotics for adults with pneumonia by meta-analysis.

Methods

Literature retrieval was completed through five databases (PubMed, Embase, Cochrane Library, Web of Science and Scopus) by the deadline of May 31, 2024. The process of study selection and data extraction were performed independently by two reviewers. The quality of observational studies and randomized controlled trial (RCT) studies were evaluated by Newcastle Ottawa scale and Jadad scale, respectively. The primary outcomes included mortality, clinical cure, and microbiological cure. Secondary outcomes were recurrence and renal impairment.

Results

There were 30 studies were analyzed, including 12 RCT studies and 18 observational studies. Inhaled antibiotics did not significantly reduce mortality in RCT studies (odds ratio (OR) = 1.06, 95 % confidence interval (CI): 0.80–1.41). Inhaled antibiotics were associated with higher rates of clinical cure (OR = 1.47 95%CI: 0.82–2.66 in RCT studies and OR = 2.09, 95%CI: 1.36–3.21 in observational studies) and microbiological cure (OR = 7.00 in RCT studies and OR = 2.20 in observational studies). Subgroup analysis showed patients received inhaled antibiotics combined with intravenous administration and inhaled amikacin had better improvements of mortality, clinical cure and microbiological cure. Inhaled antibiotics were not associated with recurrence. The pooled OR of renal impairment were 0.65 (95%CI: 0.27–1.13; I-squared = 43.5 %, P = 0.124) and 0.63(95%CI: 0.26–1.11; I-squared = 69.0 %, P = 0.110) in RCT studies and observational studies, respectively.

Conclusions

Inhaled antibiotics decreased risk of renal impairment and achieved significant improvements of clinical and microbiological cure in patients with pneumoniae.

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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
41
审稿时长
42 days
期刊介绍: Pulmonary Pharmacology and Therapeutics (formerly Pulmonary Pharmacology) is concerned with lung pharmacology from molecular to clinical aspects. The subject matter encompasses the major diseases of the lung including asthma, cystic fibrosis, pulmonary circulation, ARDS, carcinoma, bronchitis, emphysema and drug delivery. Laboratory and clinical research on man and animals will be considered including studies related to chemotherapy of cancer, tuberculosis and infection. In addition to original research papers the journal will include review articles and book reviews. Research Areas Include: • All major diseases of the lung • Physiology • Pathology • Drug delivery • Metabolism • Pulmonary Toxicology.
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