肝的抗生素治疗持续时间:系统性审查
Jennifer Curran1, Catherine Mulhall2, Ruxandra Pinto2
1Antimicrobial Stewardship Program, Sinai Health/University Health Network, Toronto, Ontario, Canada.
概括
对于发热性肝的抗生素治疗持续时间差异很大,平均为32.7天. 这种变异性并不能通过患者或感染特征来解释,这凸显了对最佳抗生素治疗的进一步研究的需要.
科学领域:
- 传染性疾病 传染性疾病
- 肝病学 肝病学是一种肝病学.
- 临床药理学 临床药理学
背景情况:
- 发烧性肝 (PLA) 是一种严重的腹内感染,需要及时治疗.
- 对PLA的最佳抗生素治疗持续时间仍未完全确定,导致实践变化.
研究的目的:
- 系统地审查和分析现有的关于抗生素治疗持续时间的肝脏的研究.
- 为了确定影响PLA抗生素治疗持续时间变化的因素.
主要方法:
- 2000年至2020年间发表的医学文献的系统审查和元分析.
- 采用随机效应元分析汇集了抗生素治疗持续时间的平均值.
- 超回归分析,以探索治疗持续时间和患者/病原体/的特征之间的关联.
主要成果:
- 参与3933名患者的16项研究提供了关于抗生素持续时间的数据.
- 平均抗生素持续时间范围广泛,从8.4至68.9天;综合平均值为32.7天 (95% CI 24.940.6),异质性非常高 (I2 = 100%).
- 在治疗持续时间和患者年龄之间没有发现显著的关联, *Klebsiella* spp. 患病率,瘤大小,多重性或管理策略.
结论:
- 目前的抗生素治疗实践存在显著的变化,用于发热性肝.
- 这种变异性并不能通过已知的患者,病原体或的特征来解释.
- 进一步的随机对照试验对于建立基于证据的指导方针来确定最佳的PLA抗生素治疗持续时间至关重要.
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