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尿动力学研究后预防性应用抗生素治疗尿路感染:荟萃分析。

Prophylactic Antibiotics for Urinary Tract Infections after Urodynamic Studies: A Meta-Analysis.

机构信息

Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.

出版信息

Biomed Res Int. 2021 Feb 28;2021:6661588. doi: 10.1155/2021/6661588. eCollection 2021.

Abstract

AIM

We aimed to perform a meta-analysis to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infections (UTIs) after urodynamic studies (UDS).

METHODS

We conducted a systematic search of PubMed, Web of Science, Ovid, Elsevier, ClinicalKey, Embase, Cochrane Library, Medline, and Wiley Online Library. Randomized controlled trials (RCTs) comparing the effectiveness of prophylactic antibiotics with placebo or no treatment in preventing UTI after UDS were included. Two reviewers extracted data independently, and RevMan 5.3 software was used to analyze relative risk (RR) with 95% confidence intervals (CI). Heterogeneity was assessed by the test and test.

RESULTS

The final meta-analysis included 1829 patients in 13 RCTs. Compared with the placebo or no treatment group, prophylactic antibiotics could significantly reduce the risk of bacteriuria (RR = 0.42, 95% CI: 0.30-0.60) and the risk of symptomatic UTI (RR = 0.65, 95% CI: 0.48-0.88). In addition, there was no statistically significant difference in the risk of adverse events (RR = 4.93, 95% CI: 0.61-40.05). No significant heterogeneity or publication bias was found in this study.

CONCLUSIONS

Current evidence showed that prophylactic antibiotics could reduce the risk of asymptomatic bacteriuria and symptomatic UTI after UDS without increasing the incidence of adverse events.

摘要

目的

我们旨在进行荟萃分析,以确定在尿动力学研究(UDS)后使用抗生素预防是否能降低尿路感染(UTI)的发生率。

方法

我们对 PubMed、Web of Science、Ovid、Elsevier、ClinicalKey、Embase、Cochrane 图书馆、Medline 和 Wiley Online Library 进行了系统检索。纳入了比较预防性抗生素与安慰剂或不治疗在 UDS 后预防 UTI 效果的随机对照试验(RCT)。两位评审员独立提取数据,使用 RevMan 5.3 软件分析相对风险(RR)及其 95%置信区间(CI)。采用 检验和 检验评估异质性。

结果

最终的荟萃分析纳入了 13 项 RCT 中的 1829 名患者。与安慰剂或不治疗组相比,预防性抗生素可显著降低菌尿(RR=0.42,95%CI:0.30-0.60)和有症状性 UTI(RR=0.65,95%CI:0.48-0.88)的风险。此外,不良反应风险(RR=4.93,95%CI:0.61-40.05)无统计学显著差异。该研究未发现显著的异质性或发表偏倚。

结论

现有证据表明,预防性抗生素可降低 UDS 后无症状菌尿和有症状性 UTI 的风险,且不会增加不良反应的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7332/7937458/cbd2e985d5f1/BMRI2021-6661588.001.jpg

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