抗生素来根除Streptococcus pyogenes无症状儿童和成年人的喉运输:一个系统性审查
Te-Yu Hung1, Linny K Phuong2, Anneke Grobler3
1Victorian Infectious Diseases Service, The Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia; Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia; Department of Paediatrics, Royal Darwin Hospital, Top End Health Service, Northern Territory, Australia.
The Journal of infection
|February 15, 2024
概括
口服10天的克林达米辛似乎是最有效的消除Streptococcus pyogenes携带. 然而,证据有限,需要对S. pyogenes的各种抗生素进行更多的研究.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
背景情况:
- 菌株Streptococcus pyogenes (S. pyogenes) 引起各种疾病,从轻微的感染到严重的败血症.
- 与S. pyogenes病例密切接触者面临着明显增加的侵入性疾病风险.
- 无症状的S. pyogenes携带和预防二次感染的管理仍然不一致.
研究的目的:
- 系统地审查抗生素治疗方案,以从无症状个体的喉中根除S. pyogenes.
- 评估不同抗生素治疗S. pyogenes携带的比较有效性.
主要方法:
- 来自PubMed,EMBASE,OVID Medline和Cochrane CENTRAL的随机对照试验 (RCT) 的系统审查.
- 纳入标准:无症状的参与者有S. pyogenes喉培养的阳性,微生物学确认 (培养 +/- PCR) 和英语出版物.
- 两个独立的审稿人进行了数据提取和偏差风险评估.
主要成果:
- 从1166个已识别的记录中,包括了3个RCT.
- 通过口服10天的克林达米辛,与类青素G与利番素相比,或用青素或红素单独治疗,表现出更高的疗效.
- 两个RCT具有偏差的高风险;一个具有偏差的低/一定风险.
结论:
- 目前对消除喉S. pyogenes携带的最佳抗生素的证据有限.
- 未来的RCT应该研究青素,素,利番素,宏类药物 (例如,阿齐思罗米) 和克林达米.
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