范科米辛最低抑制度与患有黄金葡萄球菌血流感染的患者死亡率之间的关联:系统性审查和元分析
Andre C Kalil1, Trevor C Van Schooneveld1, Paul D Fey2
1Department of Internal Medicine, Division of Infectious Disease, University of Nebraska Medical Center, Omaha.
JAMA
|October 17, 2014
概括
较高的万科米辛最小抑制度 (MIC) 在黄金杆菌菌菌病 (SAB) 中并没有显著增加死亡风险. 这次元分析发现,高和低范科米辛MIC组之间的死亡率没有统计学上显著的差异.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 药理学 药理学是指药理学的学科.
背景情况:
- 黄金葡萄球菌菌病 (SAB) 是一个重要的全球健康问题.
- 范科米辛最小抑制度 (MIC) 与SAB中的死亡率之间的关系尚未得到充分证实.
- 了解这种关联对于患者的治疗结果和公共卫生战略至关重要.
研究的目的:
- 调查SAB.患者中更高的万科米辛MIC值与死亡率之间的关联.
- 综合现有研究的证据,以确定万科米辛MIC对SAB结果的影响.
- 为了为临床决策提供有关在SAB治疗中使用万科米辛的信息.
主要方法:
- 在多个数据库 (PubMed,Embase,Cochrane Library等) 进行了全面的文献搜索. 在2014年4月之前.
- 包括报告SAB患者死亡率和万科米辛MIC的研究.
- 随机效应建模被用于对所有原因死亡率的元分析.
主要成果:
- 分析包括38项研究,其中有8291次SAB发作;整体死亡率为26.1%.
- 没有观察到高万科米辛MIC (≥1.5毫克/升) 和低万科米辛MIC (<1.5毫克/升) 的患者之间死亡率的统计学上显著差异.
- 跨不同研究设计和患者群体的子组分析没有显示出死亡风险的显著差异.
结论:
- 这次元分析发现,高万科米辛MIC与SAB.的死亡率增加之间没有统计学上显著的关联.
- 虽然不能绝对排除增加的风险,但这些发现表明,万科米辛可能仍然是SAB的可行选择,而SAB具有升高的,敏感的MIC.
- 临床解释万科米辛敏感性和考虑替代药物应以这些结果为指导.
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