Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China.
Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China.
Eur J Obstet Gynecol Reprod Biol. 2020 Dec;255:56-62. doi: 10.1016/j.ejogrb.2020.10.013. Epub 2020 Oct 10.
The purpose of this meta-analysis is to further explore the effectiveness of multidose metronidazole (MTZ) and single-dose MTZ in the treatment of trichomoniasis.
Search all the literature on MTZ for trichomoniasis in the Pubmed, Ovid Embase, Ovid MEDLIN and Cochrane Library databases. The search period is from the establishment of the database to September 10, 2020. Two authors independently screened the literatures based on inclusion and exclusion criteria, and independent extraction and integration of literature data. The main observation indicators were treatment failure rate and side-effects. Data analysis was performed using RevMan5.2 software. The risk ratio (RR) and 95 % confidence interval (CI) were used as the effect scale indicators of the counting data. P < 0.05 was considered to be statistically significant.
A total of 2114 articles were retrieved. After screening, a total of 7 articles were included, including 5 randomized controlled trial (RCT) studies and 2 case-control studies. 745 cases were treated with single-dose MTZ, and 732 cases were treated with multidose MTZ. The single-dose MTZ had a higher failure rate for trichomoniasis than the multidose MTZ, and the difference was statistically significant (RR = 1.07, 95 %CI, 1.03-1.11, P = 0.0003). When a HIV-positive study was excluded, the failure rate of the single-dose MTZ was still significantly higher than that of the multidose MTZ (RR = 1.62, 95 %CI, 1.19-2.22, P = 0.002). The side-effects of the single-dose MTZ were higher than those of the multidose MTZ, but the difference was not statistically significant (RR = 1.06, 95 %CI, 0.88-1.27, P = 0.53).
Although based on available data, multidose MTZ is more effective than single-dose MTZ for trichomoniasis, this advantage is not as obvious as previously proven. This small advantage may be lower if considering the compliance of multidose MTZ in the real world. Therefore, more high-quality studies are needed to confirm this before suggesting a multidose MTZ as the first line treatment for HIV-negative trichomoniasis.
本荟萃分析旨在进一步探讨多剂量甲硝唑（MTZ）和单剂量 MTZ 在治疗滴虫病方面的疗效。
在 Pubmed、Ovid Embase、Ovid MEDLIN 和 Cochrane Library 数据库中搜索所有关于 MTZ 治疗滴虫病的文献。检索时间从数据库建立到 2020 年 9 月 10 日。两位作者根据纳入和排除标准独立筛选文献，并对文献数据进行独立提取和整合。主要观察指标为治疗失败率和不良反应。采用 RevMan5.2 软件进行数据分析。计数资料的效应尺度指标采用风险比（RR）和 95%置信区间（CI）。P<0.05 为差异有统计学意义。
共检索到 2114 篇文章。经过筛选，共纳入 7 篇文献，其中 5 篇为随机对照试验（RCT）研究，2 篇为病例对照研究。745 例患者接受单剂量 MTZ 治疗，732 例患者接受多剂量 MTZ 治疗。单剂量 MTZ 治疗滴虫病的失败率高于多剂量 MTZ，差异有统计学意义（RR=1.07，95%CI，1.03-1.11，P=0.0003）。排除 HIV 阳性研究后，单剂量 MTZ 的失败率仍显著高于多剂量 MTZ（RR=1.62，95%CI，1.19-2.22，P=0.002）。单剂量 MTZ 的不良反应发生率高于多剂量 MTZ，但差异无统计学意义（RR=1.06，95%CI，0.88-1.27，P=0.53）。
虽然基于现有数据，多剂量 MTZ 治疗滴虫病比单剂量 MTZ 更有效，但这种优势并不像之前证明的那样明显。如果考虑到多剂量 MTZ 在现实世界中的依从性，这种优势可能会更低。因此，需要更多高质量的研究来证实这一点，然后才能建议多剂量 MTZ 作为 HIV 阴性滴虫病的一线治疗药物。
