治疗急性中耳炎的抗生素:对个体患者数据的元分析
Maroeska M Rovers1, Paul Glasziou, Cees L Appelman
1Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands. M.Rovers@umcutrecht.nl
Lancet (London, England)
|October 24, 2006
概括
抗生素在患有双边感染或耳部泄漏的幼儿中对急性中耳炎最有效. 对于轻微的病例,观察可能足够. 这项研究分析了儿童抗生素的有效性.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
背景情况:
- 对儿童急性中耳炎抗生素有效性的单个试验往往太小,无法进行子组分析.
- 确定最受益于抗生素的特定儿童子组至关重要.
研究的目的:
- 确定患有急性中耳炎的儿童的子组,这些子组从抗生素治疗中获益更多.
- 为指导儿童群体急性中耳炎的抗生素处方.
主要方法:
- 一项对6项随机试验的元分析,涉及1643名患有中耳炎的儿童 (6个月至12岁).
- 单个患者的数据被验证并重新分析以评估结果.
- 主要结局:急性中耳炎的延长过程 (疼痛,发烧或两者在3-7天).
主要成果:
- 观察到耳 (耳部排泄) 和年龄相结合双边急性中耳炎的显著效果变化.
- 在患有双边急性中耳炎的2岁以下儿童中,抗生素减少了25%的症状 (NNT=4).
- 在患有耳的儿童中,抗生素的益处比没有抗生素的儿童更大 (NNT=3).
结论:
- 抗生素对两岁以下的双边急性中耳炎患者和耳鼻患者最有益.
- 对大多数患有轻度急性中耳炎的儿童来说,观察方法是合理的.
- 根据特定的临床特征量身定制抗生素的使用,可以提高治疗效率.
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