聚维酮碘治疗感染性角膜炎的系统评价

Waleed K. Alsarhani , Amy Basilious , Marko M. Popovic , Sara Alshaker , Clara C. Chan
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引用次数: 0

摘要

目的评价聚维酮碘(PI)治疗感染性角膜炎的有效性和安全性。DesignSystematic审查。方法系统回顾Ovid MEDLINE、EMBASE和Cochrane Library的相关文献。结果包括最佳矫正视力、浸润、溃疡大小和菌落形成单位(cfu)。所有以英文发表的随机临床试验(RCTs)和观察性研究均被纳入。结果共鉴定出221篇。在对题目和摘要进行筛选后,对15篇文章进行全文审查。3个随机对照试验、1个队列和4个病例报告符合纳入标准。在一项研究中,在等待培养结果时,PI被证明是减少浸润和溃疡大小的有效治疗方法。另一项研究发现,在实现恢复和假定治愈方面,PI和抗生素治疗没有显著差异。然而,另外两项研究报告说,当加入标准抗生素治疗时,PI并没有显著降低CFU或改善视力结果。没有研究报道局部PI有任何安全性问题。结论一些研究表明,PI在感染性角膜炎的治疗中可能有潜在的益处,而另一些研究发现,与安慰剂或局部抗生素治疗相比,PI没有显著差异。目前的证据受限于小样本量和研究设计、人群、结果测量和PI浓度的异质性。建议采用更大样本量的随机对照试验,以及标准化的PI浓度、持续时间和结果测量,以确认PI治疗感染性角膜炎的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Povidone-iodine in the treatment of infectious keratitis: A systematic review

Purpose

To evaluate if povidone-iodine (PI) is effective and safe in the treatment of infectious keratitis.

Design

Systematic review.

Methods

A systematic review of Ovid MEDLINE, EMBASE, and Cochrane Library was conducted to find relevant published articles. Outcomes including best corrected visual acuity, infiltrate, ulcer size and colony forming units (CFUs) were collected. All randomized clinical trials (RCTs) and observational studies published in English were included.

Results

A total of 221 articles were identified. After screening of titles and abstracts, 15 articles underwent full-text review. Three RCTs, one cohort and four case reports met the inclusion criteria. In one study, PI was shown to be an effective treatment in reducing infiltrate and ulcer size while waiting for culture results. Another study found no significant difference between PI and antibiotic treatment in achieving recovery and presumed cure. However, two other studies reported that PI did not significantly reduce CFU or improve visual outcomes when added to standard antibiotic treatment. None of the studies reported any safety concerns with topical PI.

Conclusions

Some studies suggest that PI may have potential benefits in the management of infectious keratitis, while others found no significant differences relative to placebo or when added to topical antibiotic treatment. . The current evidence is limited by small sample sizes and heterogeneity in study design, populations, outcome measures, and PI concentrations. RCTs with a larger sample size, and standardized PI concentrations, durations, and outcome measures are recommended to confirm the efficacy of PI in the treatment of infectious keratitis.
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