青霉素与基于甲氧苄啶的方案治疗慢性支气管炎急性细菌感染：随机对照试验的荟萃分析

Penicillins vs trimethoprim-based regimens for acute bacterial exacerbations of chronic bronchitis: meta-analysis of randomized controlled trials.

作者信息

Korbila Ioanna P, Manta Katerina G, Siempos Ilias I, Dimopoulos George, Falagas Matthew E

机构信息

Alfa Institute of Biomedical Sciences in Athens, Greece.

出版信息

Can Fam Physician. 2009 Jan;55(1):60-7.

PMID:19155372

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2628840/

Abstract

OBJECTIVE

To compare the effectiveness and toxicity of semisynthetic penicillins (SSPs) (amoxicillin, ampicillin, pivampicillin) and trimethoprim-based regimens (trimethoprim, trimethoprim-sulfamethoxazole, trimethoprim-sulfadiazine) in treating acute bacterial exacerbations of chronic bronchitis (ABECB).

DATA SOURCES

We searched MEDLINE, EMBASE, Current Contents, and the Cochrane Central Register of Controlled Trials to identify and extract data from relevant randomized controlled trials (RCTs).

STUDY SELECTION

Only RCTs comparing penicillins with trimethoprim-based regimens for the treatment of patients with ABECB that reported data on effectiveness, toxicity, or mortality were considered eligible for this meta-analysis.

SYNTHESIS

Out of 134 RCTs identified in the search, 5 RCTs involving 287 patients were included in the analysis. There were no differences between patients with ABECB treated with SSPs and those treated with trimethoprim, alone or in combination with a sulfonamide, in treatment success (intention-to-treat patients: n = 262, odds ratio [OR] 1.68, 95% confidence interval [CI] 0.91-3.09; clinically evaluable patients: n = 246, OR 1.59, 95% CI 0.79-3.20) or number of drug-related adverse events in general (n = 186 patients, OR 0.37, 95% CI 0.11-1.24), frequency of diarrhea or skin rashes, or number of withdrawals due to adverse events (n = 179 patients, OR 0.27, 95% CI 0.07-1.03).

CONCLUSION

Based on limited evidence leading to wide CIs of the estimated treatment effects, SSPs and trimethoprim-based regimens seem to be equivalent in terms of effectiveness and toxicity for ABECB.

摘要

目的

比较半合成青霉素（SSPs，即阿莫西林、氨苄西林、匹氨西林）和基于甲氧苄啶的治疗方案（甲氧苄啶、甲氧苄啶 - 磺胺甲恶唑、甲氧苄啶 - 磺胺嘧啶）在治疗慢性支气管炎急性细菌加重期（ABECB）时的有效性和毒性。

数据来源

我们检索了MEDLINE、EMBASE、《现刊目次》和Cochrane对照试验中央注册库，以识别并从相关随机对照试验（RCTs）中提取数据。

研究选择

仅纳入那些比较青霉素与基于甲氧苄啶的治疗方案治疗ABECB患者且报告了有效性、毒性或死亡率数据的RCTs进行该荟萃分析。

合成

在检索到的134项RCTs中，5项涉及287例患者的RCTs被纳入分析。接受SSPs治疗的ABECB患者与接受甲氧苄啶单独治疗或与磺胺类药物联合治疗的患者在治疗成功率方面（意向性治疗患者：n = 262，比值比[OR] 1.68，95%置信区间[CI] 0.91 - 3.09；临床可评估患者：n = 246，OR 1.59，95% CI 0.79 - 3.20），或总体药物相关不良事件数量（n = 186例患者，OR 0.37，95% CI 0.11 - 1.24）、腹泻或皮疹发生率，或因不良事件导致的退出治疗人数（n = 179例患者，OR 0.27，95% CI 0.07 - 1.03）方面均无差异。