经验性大环内酯类与氟喹诺酮类药物治疗与非典型细菌相关的社区获得性肺炎的疗效：荟萃分析。
Efficacy of empiric macrolides versus fluoroquinolones in community-acquired pneumonia associated with atypical bacteria: A meta-analysis.
机构信息
Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia.
出版信息
Respir Med Res. 2022 Nov;82:100931. doi: 10.1016/j.resmer.2022.100931. Epub 2022 Jun 20.
INTRODUCTION
It is unclear if one empiric regimen for community-acquired pneumonia (CAP) associated with atypical bacteria is superior to another. The objective of this meta-analysis was to compare fluoroquinolones to macrolides in the rates of clinical failure in CAP associated with atypical pathogens.
METHODS
We searched PubMed and EMBASE databases for randomized controlled trials (RCTs) comparing the clinical efficacy of fluoroquinolones with macrolides for CAP associated with atypical bacteria. We estimated risk differences (RRs) with 95% confidence intervals (CIs) using random-effects models and assessed for heterogeneity (I).
RESULTS
Five RCTs met the inclusion criteria. No significant differences between macrolides and fluoroquinolones and were identified in rates of clinical failure in CAP associated with any atypical bacteria (RR = 1.57 [95% CI 0.73 to 3.38]; p = 0.251; I = 0%), Chlamydia pneumoniae (RR = 2.12 [95% CI 0.63 to 7.14]; p = 0.223; I = 0%), Mycoplasma pneumoniae (RR = 1.28 [95% CI 0.57 to 2.92]; p = 0.550; I = 0%), or Legionella pneumophila (RR = 0.24 [95% CI 0.02 to 2.86]; p = 0.256; I = 0%).
CONCLUSIONS
This meta-analysis of RCTs found no significant differences between macrolides and fluoroquinolones in rates of clinical failure in CAP associated with atypical bacteria.
简介
目前尚不清楚针对伴有非典型病原体的社区获得性肺炎（CAP），使用一种经验性治疗方案是否优于另一种方案。本荟萃分析的目的是比较氟喹诺酮类药物与大环内酯类药物治疗伴有非典型病原体的 CAP 的临床失败率。
方法
我们检索了 PubMed 和 EMBASE 数据库中比较氟喹诺酮类药物与大环内酯类药物治疗伴有非典型细菌的 CAP 的临床疗效的随机对照试验（RCT）。我们使用随机效应模型估计风险差异（RR）及其 95%置信区间（CI），并评估异质性（I）。
结果
有 5 项 RCT 符合纳入标准。在伴有任何非典型细菌的 CAP 中，大环内酯类药物与氟喹诺酮类药物的临床失败率之间未发现显著差异（RR=1.57 [95% CI 0.73 至 3.38]；p=0.251；I=0%）、肺炎衣原体（RR=2.12 [95% CI 0.63 至 7.14]；p=0.223；I=0%）、肺炎支原体（RR=1.28 [95% CI 0.57 至 2.92]；p=0.550；I=0%）或嗜肺军团菌（RR=0.24 [95% CI 0.02 至 2.86]；p=0.256；I=0%）。
结论
本 RCT 荟萃分析发现，伴有非典型细菌的 CAP 患者中，大环内酯类药物与氟喹诺酮类药物的临床失败率无显著差异。
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