Wang Jinghua, Xu Haiyang, Liu Pan, Li Mingxian
Pediatric of Rheumatology, Immunology and Allergy, The First Hospital of Jilin University, Changchun.
Department of Anesthesiology, The First Hospital of Jilin University, Changchun.
Int J Chron Obstruct Pulmon Dis. 2017 Aug 9;12:2391-2405. doi: 10.2147/COPD.S139521. eCollection 2017.
The purpose of this study was to compare the relative efficacy and safety of different antibiotic drugs and recommend superior regimens in the treatment of bronchitis. With respect to the antibiotic comparisons against quinolones in terms of intention-to-treat patients, we concluded that quinolones had advantages over placebo, β-lactams, sulfonamides, and double β-lactams. Concerning treatment methods for clinically evaluable patients, quinolones demonstrated better performance than β-lactams and sulfonamides. The secondary effects of macrolides, quinolones, and double β-lactams were significantly more adverse than β-lactams with odds ratios (ORs) of 1.5 (95% credible interval [CrI] =1.1-2.0), 1.7 (95% CrI =1.2-2.3), and 2.7 (95% CrI =1.8-4.1), respectively. Significant differences in the prevalence of diarrhea as a secondary effect were only identified among the comparisons of double β-lactams against β-lactams and macrolides (OR =5.0, 95% CrI =2.1-12.0; OR =3.0, 95% CrI =1.7-5.4, respectively). Quinolones can be recommended as the superior treatment for bronchitis, in accordance with our cluster analysis with surface under the cumulative ranking curve. The primary outcomes of network meta-analysis indicated that quinolones showed the best performance among the 8 treatments studied, although β-lactams showed the lowest risk of adverse side effects. Quinolones are recommended as the primary treatment option for bronchitis patients, having taking into account the success rates and safety profiles of the eight drugs studied here.
本研究的目的是比较不同抗生素药物的相对疗效和安全性，并推荐治疗支气管炎的更佳方案。就意向性治疗患者中抗生素与喹诺酮类药物的比较而言，我们得出结论，喹诺酮类药物优于安慰剂、β-内酰胺类、磺胺类和双β-内酰胺类。关于临床可评估患者的治疗方法，喹诺酮类药物的表现优于β-内酰胺类和磺胺类。大环内酯类、喹诺酮类和双β-内酰胺类的次要效应明显比β-内酰胺类更具不良性，优势比（OR）分别为1.5（95%可信区间[CrI]=1.1-2.0）、1.7（95%CrI=1.2-2.3）和2.7（95%CrI=1.8-4.1）。仅在双β-内酰胺类与β-内酰胺类和大环内酯类的比较中发现腹泻作为次要效应的发生率存在显著差异（OR分别为5.0，95%CrI=2.1-12.0；OR=3.0，95%CrI=1.7-5.4）。根据我们累积排序曲线下面积的聚类分析，喹诺酮类药物可被推荐为支气管炎的更佳治疗药物。网状Meta分析的主要结果表明，喹诺酮类药物在所研究的8种治疗方法中表现最佳，尽管β-内酰胺类药物的副作用风险最低。考虑到这里研究的8种药物的成功率和安全性，喹诺酮类药物被推荐为支气管炎患者的主要治疗选择。
