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碳青霉烯类抗生素的安全性概况:FDA 不良事件报告系统的数据挖掘。

Safety profile of carbapenems: Data mining of the FDA adverse events reporting system.

出版信息

Int J Clin Pharmacol Ther. 2021 Sep;59(9):594-602. doi: 10.5414/CP203811.

Abstract

OBJECTIVE

To learn the safety profile of carbapenems and compare suspected adverse drug reactions (ADRs) among carbapenem classes by data mining the FDA adverse event reporting system (FAERS) database.

MATERIALS

This retrospective study described the general characteristics of adverse drug event (ADE) reports related to carbapenems in the FAERS during 2015 - 2018.

METHODS

The 95% confidence intervals (CIs) of proportional reporting ratio (PRR), the reporting odds ratio (ROR), and information component (IC) of Bayesian confidence propagation neural network (BCPNN) were calculated to identify potential safety signals.

RESULTS

A total number of 5,899 reports associated with carbapenems were submitted to the FAERS from January 1, 2015 to December 31, 2018. The most frequently reported ADE associated with carbapenems was drug ineffective (10.51%). Serious ADEs and death associated with carbapenems were reported in 41.24 and 25.12%, respectively. Infections and infestations was the strongest signal detected in both meropenem and imipenem. Nervous system disorders and psychiatric disorders were strongly detected in ertapenem. Hepatobiliary disorders were common in doripenem patients.

CONCLUSION

Carbapenem resistance is alarming in the United States, and carbapenem is more likely to be associated with serious and fatal ADEs among β-lactam antibiotics. Both differences and similarities exist in the safety profile among carbapenems classes. Close attention should be paid to patients with special disease when administrated carbapenems.

摘要

目的

通过挖掘 FDA 不良事件报告系统(FAERS)数据库,了解碳青霉烯类药物的安全性概况,并比较碳青霉烯类药物之间可疑药物不良反应(ADR)的发生情况。

材料

本回顾性研究描述了 2015 年至 2018 年 FAERS 中与碳青霉烯类药物相关的不良药物事件(ADE)报告的一般特征。

方法

计算了比例报告比值(PRR)、报告比值比(ROR)和贝叶斯置信传播神经网络(BCPNN)的信息分量(IC)的 95%置信区间(CI),以识别潜在的安全信号。

结果

从 2015 年 1 月 1 日至 2018 年 12 月 31 日,向 FAERS 提交了与碳青霉烯类药物相关的 5899 份报告。与碳青霉烯类药物相关的最常见 ADR 是药物无效(10.51%)。报告了与碳青霉烯类药物相关的严重 ADR 和死亡分别为 41.24%和 25.12%。在美罗培南和亚胺培南中,感染和寄生虫感染是最强的信号。在厄他培南中,神经系统疾病和精神疾病被强烈检测到。在多利培南患者中,肝胆疾病较为常见。

结论

在美国,碳青霉烯类药物的耐药性令人担忧,在β-内酰胺类抗生素中,碳青霉烯类药物更有可能与严重和致命的 ADR 相关。碳青霉烯类药物之间的安全性概况既有差异也有相似之处。在使用碳青霉烯类药物时,应特别注意特殊疾病的患者。

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