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替加环素治疗艰难梭菌感染患者:临床证据的更新。

Tigecycline for the treatment of patients with Clostridium difficile infection: an update of the clinical evidence.

机构信息

Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece.

Department of Medicine, Henry Dunant Hospital Center, Athens, Greece.

出版信息

Eur J Clin Microbiol Infect Dis. 2020 Jun;39(6):1053-1058. doi: 10.1007/s10096-019-03756-z. Epub 2020 Jan 11.

Abstract

PURPOSE

Clostridium difficile infection (CDI) is the most common cause of nosocomial diarrhea in adult patients and is associated with considerable morbidity and mortality. Apart from the standard treatment regimens, tigecycline has shown significant in vitro activity against C. difficile but data regarding its clinical impact remains controversial. The aim of this article is to update the evidence related to the clinical role of tigecycline against C. difficile.

METHODS

PubMed and Scopus databases were searched for relevant literature published from January 2015 to July 2018.

RESULTS

Six retrospective cohort studies, 1 prospective study, 1 case series, and 2 case reports provided data regarding the effectiveness of tigecycline against C. difficile and were included in our evaluation. Also, we performed a meta-analysis based on 186 patients (from 4 studies) that showed clinical cure 79% (95% CI 73.0-84.5%).

CONCLUSION

Despite the heterogeneity of the included studies and the small number of patients, the available evidence suggests that tigecycline might be considered as a potential therapeutic option for patients with CDIs, especially in severe cases.

摘要

目的

艰难梭菌感染(CDI)是成人患者医院获得性腹泻的最常见原因,与相当大的发病率和死亡率有关。除了标准治疗方案外,替加环素对艰难梭菌具有显著的体外活性,但关于其临床影响的数据仍存在争议。本文旨在更新与替加环素治疗艰难梭菌相关的临床作用的证据。

方法

在 PubMed 和 Scopus 数据库中搜索了 2015 年 1 月至 2018 年 7 月期间发表的相关文献。

结果

6 项回顾性队列研究、1 项前瞻性研究、1 项病例系列研究和 2 项病例报告提供了关于替加环素对艰难梭菌的疗效的数据,并纳入了我们的评估。此外,我们对 186 名患者(来自 4 项研究)进行了荟萃分析,结果显示临床治愈率为 79%(95%CI 73.0-84.5%)。

结论

尽管纳入研究的异质性和患者数量较少,但现有证据表明,替加环素可能被视为治疗艰难梭菌感染患者的潜在治疗选择,尤其是在严重病例中。

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