托西菲林用于治疗新生儿的败血症和死性肠球炎
1Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
The Cochrane database of systematic reviews
|June 20, 2023
概括
作为新生儿败血症的辅助疗法,托西菲林 (PTX) 可能会减少死亡率和住院时间. 然而,证据的确定性很低,PTX尚未被研究为死结肠炎 (NEC).
科学领域:
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 新生儿败血症和死性肠球炎 (NEC) 导致高死亡率和发病率.
- 炎症调节可能会改善新生儿的治疗结果.
- 作为一种潜在的辅助疗法,正在探索一种固酶抑制剂托西菲林 (PTX).
研究的目的:
- 评估静脉注射PTX与新生儿败血症和NEC的抗生素联合的有效性和安全性.
- 评估PTX对新生儿死亡率和发病率的影响.
主要方法:
- 随机对照试验 (RCT) 和准RCT的系统审查和元分析.
- 搜索了多个数据库 (CENTRAL,MEDLINE,Embase,CINAHL) 和试验登记册,截至2022年7月.
- 将PTX与抗生素与安慰剂与抗生素相比较,或PTX与抗生素加上其他辅助剂.
主要成果:
- 包括6项涉及416名患有败血症的新生儿的RCT;没有对NEC的研究.
- 与抗生素一起的PTX可以减少全因死亡率 (低确定性证据) 和住院时间.
- 关于PTX对慢性肺病,心室内出血,心室周白血病,NEC或早产视网膜病变的影响的证据非常不确定.
结论:
- 新生儿败血症的辅助PTX治疗显示出降低死亡率和住院时间的潜力,没有报告的不良影响,但证据的确定性很低.
- 需要进一步的精心设计的多中心试验来确认PTX在新生儿败血症和NEC的疗效和安全性.
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