Yurkowski P J, Plaisance K I
Department of Pharmacy, University of Cincinnati Hospital, Ohio.
Pharmacotherapy. 1993 Sep-Oct;13(5):494-9.
Meta-analysis methods were used to compare the effect of antibiotic regimens and corticosteroids on the development of auditory sequelae after pediatric bacterial meningitis. After a literature search of two major data bases, 11 studies met the criteria and were included in the analysis. Summary odds ratios, with 95% confidence intervals, were calculated that quantified the relative risk of developing auditory sequelae after specific therapies. No significant differences among antibiotics were identified in terms of reducing the risk of meningitis-related hearing impairment. However, corticosteroids significantly reduced the frequency of bilateral, moderate, or greater hearing loss. Patients receiving placebo versus dexamethasone were much more likely to develop auditory dysfunction (odds ratio 3.77; 95% CI 1.77-8.10). The results of this study add quantitative evidence supporting the use of dexamethasone as adjunctive therapy in pediatric bacterial meningitis.
采用荟萃分析方法比较抗生素治疗方案和皮质类固醇对小儿细菌性脑膜炎后听觉后遗症发生的影响。在检索两个主要数据库的文献后，有11项研究符合标准并纳入分析。计算了汇总比值比及其95%置信区间，以量化特定治疗后发生听觉后遗症的相对风险。在降低脑膜炎相关听力损害风险方面，未发现不同抗生素之间存在显著差异。然而，皮质类固醇显著降低了双侧、中度或更严重听力损失的发生率。接受安慰剂与地塞米松治疗的患者发生听觉功能障碍的可能性要高得多（比值比3.77；95%置信区间1.77 - 8.10）。本研究结果增加了支持地塞米松作为小儿细菌性脑膜炎辅助治疗药物的定量证据。
