Department of Pediatric Surgery, West China Hospital of Sichuan University, #37 Guo-Xue-Xiang, Chengdu, 610041, China.
BMC Pediatr. 2019 Nov 4;19(1):407. doi: 10.1186/s12887-019-1799-6.
The use of oral (PO) antibiotics following a course of certain intravenous (IV) antibiotics is proposed in order to avoid the complications of IV medications and to decrease the cost. However, the efficacy and safety of sequential IV/PO antibiotics is unclear and requires further study.
The databases, including PubMed, EMBASE and Cochrane Library, were searched. Studies comparing outcomes in patients with perforated appendicitis receiving sequential IV/PO and PO antibiotics therapy were screened. The Newcastle-Ottawa Scale (NOS) and the Jadad score were used to evaluate the quality of the cohort and the randomized controlled portions of the trial, respectively. Statistical heterogeneity was assessed using the I value. A fixed or random-effect model was applied according to the I value.
Five controlled studies including a total of 580 patients were evaluated. The pooled estimates revealed that sequential IV/PO antibiotic therapy did not increase the risk of complications, with a risk ratio (RR) of 0.97 (95% CI 0.51-1.83, P = 0.93) for postoperative abscess, 1.04 (95% CI 0.25-4.36, P = 0.96) for wound infection and 0.62 (95% CI 0.33-1.16, P = 0.13) for readmission.
Our study demonstrates that sequential IV/PO antibiotic therapy is noninferior to IV antibiotic therapy regarding postoperative abscess, wound infection and readmission.
为了避免静脉（IV）药物治疗的并发症和降低成本，在使用某些静脉抗生素治疗后，建议使用口服（PO）抗生素。然而，序贯 IV/PO 抗生素的疗效和安全性尚不清楚，需要进一步研究。
检索了包括 PubMed、EMBASE 和 Cochrane Library 在内的数据库。筛选了比较接受序贯 IV/PO 和 PO 抗生素治疗的穿孔性阑尾炎患者结局的研究。使用纽卡斯尔-渥太华量表（NOS）和 Jadad 评分分别评估队列研究和随机对照部分的质量。使用 I ²值评估统计异质性。根据 I ²值应用固定或随机效应模型。
评估了 5 项包括 580 名患者的对照研究。汇总估计表明，序贯 IV/PO 抗生素治疗不会增加并发症的风险，术后脓肿的风险比（RR）为 0.97（95%CI 0.51-1.83，P=0.93），伤口感染的 RR 为 1.04（95%CI 0.25-4.36，P=0.96），再入院的 RR 为 0.62（95%CI 0.33-1.16，P=0.13）。
我们的研究表明，序贯 IV/PO 抗生素治疗在术后脓肿、伤口感染和再入院方面与 IV 抗生素治疗无差异。
