Fischbach Wolfgang, Andresen Viola, Eberlin Marion, Mueck Tobias, Layer Peter
Medizinische Klinik II, Klinikum Aschaffenburg-Alzenau , Aschaffenburg , Germany.
Medizinische Klinik, Israelitisches Krankenhaus , Hamburg , Germany.
Front Med (Lausanne). 2016 Oct 14;3:44. doi: 10.3389/fmed.2016.00044. eCollection 2016.
Racecadotril is a guideline-recommended treatment to alleviate symptoms of acute diarrhea. A systematic review of randomized studies was performed comparing efficacy and safety of treatment with racecadotril to that with placebo or active treatments in adults. In five double-blind studies, racecadotril and placebo had comparable tolerability, but racecadotril was more effective. This was consistent across multiple efficacy parameters including duration of diarrhea, number of diarrheic stools, abdominal pain, and meteorism; it was also consistent across countries in Africa, Asia, and Europe. In six randomized studies in outpatients comparing racecadotril to loperamide, resolution of symptoms occurred with similar speed and efficacy; however, racecadotril treatment was associated with less rebound constipation and less abdominal discomfort. The seventh comparative study performed in geriatric nursing home residents reported a superior efficacy of racecadotril. In direct comparison with treatment, racecadotril exhibited similar tolerability but was more efficacious. One study compared racecadotril to octreotide in patients with acute diarrhea requiring hospitalization, rehydration, and antibiotic treatment; in this cohort, octreotide was more efficacious than racecadotril. In conclusion, in adults with acute diarrhea, racecadotril is more efficacious than placebo or , similarly efficacious as loperamide and, in patients with moderate to severe disease as add-on to antibiotics, less than octreotide. The tolerability of racecadotril is similar to that of placebo or and better than that of loperamide, particularly with regard to risk of rebound constipation. Taken together, these data demonstrate that racecadotril is a suitable treatment to alleviate symptoms of acute diarrhea in adults.
消旋卡多曲是指南推荐的缓解急性腹泻症状的治疗药物。我们进行了一项随机研究的系统评价，比较了消旋卡多曲与安慰剂或成人活性治疗药物的疗效和安全性。在五项双盲研究中，消旋卡多曲和安慰剂的耐受性相当，但消旋卡多曲更有效。这在多个疗效参数中都是一致的，包括腹泻持续时间、腹泻次数、腹痛和腹胀；在非洲、亚洲和欧洲的各个国家也是一致的。在六项门诊患者的随机研究中，将消旋卡多曲与洛哌丁胺进行比较，症状缓解的速度和疗效相似；然而，消旋卡多曲治疗导致的反弹性便秘和腹部不适较少。在老年疗养院居民中进行的第七项比较研究报告了消旋卡多曲具有更高的疗效。与[未提及药物名称]治疗直接比较时，消旋卡多曲表现出相似的耐受性但更有效。一项研究在需要住院、补液和抗生素治疗的急性腹泻患者中将消旋卡多曲与奥曲肽进行了比较；在该队列中，奥曲肽比消旋卡多曲更有效。总之，在患有急性腹泻的成人中，消旋卡多曲比安慰剂或[未提及药物名称]更有效，与洛哌丁胺疗效相似，在中度至重度疾病患者中作为抗生素的附加用药时，疗效低于奥曲肽。消旋卡多曲的耐受性与安慰剂或[未提及药物名称]相似，且优于洛哌丁胺，特别是在反弹性便秘风险方面。综上所述，这些数据表明消旋卡多曲是缓解成人急性腹泻症状的合适治疗药物。
