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儿童 感染多种治疗方案的比较:网状荟萃分析。

Comparison of multiple treatment regimens in children with infection: A network meta-analysis.

机构信息

Department of Pediatrics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

Jiangsu Key Laboratory of Pediatric Respiratory Disease, Institute of Pediatrics, Medical Metabolomics Center, Nanjing University of Chinese Medicine, Nanjing, China.

出版信息

Front Cell Infect Microbiol. 2023 Feb 23;13:1068809. doi: 10.3389/fcimb.2023.1068809. eCollection 2023.

Abstract

BACKGROUND

Multiple regimens have been widely used in the eradication treatment of infection in children. However, there is a lack of comparison and evaluation of their effectiveness in different regions of the world.

METHODS

Randomized controlled trials were retrieved. Review Manager 5.4, Stata SE 15 and R 4.0.4 statistical software were used to analyze date. The ranking probability is assessed according to the surfaces under cumulative ranking (SUCRA).

RESULTS

163 studies were eligible for this study, involving 336 arms and 18,257 children, and 10 different interventions. The results showed that the eradication rates of sequential therapy with probiotics (SP), bismuth-containing quadruple (Quadruple) therapy, concomitant therapy and PCN therapy were at least 90%. Cumulative ranking showed that SP therapy had the best eradication effect (SUCRA 92.7%) whereas Bismuth-containing triple therapy (B) had the worst (SUCRA 3.5%). Subgroup analysis suggested that SP therapy ranked first in China and other regions, and the ranking of Triple therapy with probiotics therapy (TP) was equally stable (SUCRA 72.0% 76.4% respectively). The security of the SP and TP therapy had great advantages.

CONCLUSIONS

As for the eradication treatment of infection in children, SP therapy ranks highest. SP and TP therapies are most safe.

摘要

背景

多种方案已广泛用于儿童感染的根除治疗。然而,缺乏对世界不同地区这些方案有效性的比较和评估。

方法

检索随机对照试验。使用 Review Manager 5.4、Stata SE 15 和 R 4.0.4 统计软件对数据进行分析。根据累积排序面(SUCRA)评估排序概率。

结果

共有 163 项研究符合纳入标准,涉及 336 个组和 18257 名儿童,10 种不同的干预措施。结果显示,益生菌序贯疗法(SP)、含铋四联疗法(Quadruple)、同时疗法和 PCN 疗法的根除率至少为 90%。累积排序显示 SP 疗法具有最佳的根除效果(SUCRA 92.7%),而含铋三联疗法(B)的效果最差(SUCRA 3.5%)。亚组分析表明,SP 疗法在中国和其他地区排名第一,益生菌三联疗法(TP)的排名同样稳定(SUCRA 分别为 72.0%和 76.4%)。SP 和 TP 疗法的安全性具有很大优势。

结论

对于儿童感染的根除治疗,SP 疗法排名最高。SP 和 TP 疗法最安全。

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