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替考拉宁与万古霉素治疗耐甲氧西林金黄色葡萄球菌感染的比较:一项荟萃分析。

A comparison of telavancin and vancomycin for treatment of methicillin-resistant Staphylococcus aureus infections: A meta-analysis.

作者信息

Liu Yu, Wang Juan

出版信息

Int J Clin Pharmacol Ther. 2017 Nov;55(11):839-845. doi: 10.5414/CP202996.

Abstract

OBJECTIVE

The objective of this study was to systematically review and evaluate the efficacy and safety of telavancin and vancomycin in the treatment of infections due to methicillin-resistant Staphylococcus aureus (MRSA).

MATERIALS AND METHODS

We performed a systematic literature search using Pubmed, Embase, VIP Chinese Science and Technique Journals Database, and Wanfang Database resulting in the inclusion of seven publications in this study. Outcomes were calculated using pooled relative risk (RR) and 95% confidence interval (CI). Publication bias was also assessed.

RESULTS

Seven studies comparing telavancin with vancomycin in the treatment of MRSA-caused infections were included in the analysis. There was a higher treatment success rate (reported as clinical evaluation, 1,420 patients, RR = 1.05, 95% CI = 1.01 - 1.10) in telavancin compared to vancomycin. However, there was also a significant difference in serious adverse events reported (3,622 patients, RR = 1.28, 95% CI = 1.11 - 1.50) when comparing telavancin with vancomycin. The results also showed increased creatinine level (3,185 patients, RR = 2.13, 95% CI = 1.72 - 2.64) in telavancin treatment.

CONCLUSION: Telavancin is a reliable alternative to vancomycin in the treatment of MRSA-confirmed infections despite the incidence of serious adverse events. The potential for telavancin-induced serious adverse events and nephrotoxicity should be taken into consideration before treatment.
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摘要

目的

本研究的目的是系统评价和评估替考拉宁和万古霉素治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染的疗效和安全性。

材料与方法

我们使用PubMed、Embase、维普中文科技期刊数据库和万方数据库进行了系统的文献检索,本研究纳入了7篇出版物。使用合并相对风险(RR)和95%置信区间(CI)计算结果。还评估了发表偏倚。

结果

分析纳入了7项比较替考拉宁与万古霉素治疗MRSA引起的感染的研究。与万古霉素相比,替考拉宁的治疗成功率更高(以临床评估报告,1420例患者,RR = 1.05,95%CI = 1.01 - 1.10)。然而,在比较替考拉宁与万古霉素时,报告的严重不良事件也存在显著差异(3622例患者,RR = 1.28,95%CI = 1.11 - 1.50)。结果还显示,替考拉宁治疗时肌酐水平升高(3185例患者, RR = 2.13,95%CI = 1.72 - 2.64)。

结论

尽管存在严重不良事件的发生率,但替考拉宁在治疗确诊的MRSA感染方面是万古霉素的可靠替代药物。在治疗前应考虑替考拉宁引起严重不良事件和肾毒性的可能性。

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