抗生素治疗狂妄症的老年人与炎症或细菌症:一个系统的审查
Nathan M Stall1,2,3, Christopher Kandel3,4, Christina Reppas-Rindlisbacher1,2,3
1Division of General Internal Medicine and Geriatrics, Sinai Health and the University Health Network, Toronto, Canada.
Journal of the American Geriatrics Society
|June 19, 2024
概括
这次系统性审查没有发现任何证据表明,抗生素可以改善无症状尿路发现的老年人痴呆症的结果. 有限的,有偏见的证据表明,抗生素可能会使这些患者的妄想恶化.
科学领域:
- 老年学是一门学科.
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 痴呆症是老年人常见的担忧.
- 抗生素在与无症状细菌性尿症或炎症相关的痴呆症中的作用还不清楚.
- 在老年患者中,区分感染与殖民是至关重要的.
研究的目的:
- 系统地审查抗生素治疗对老年人狂妄症或细菌性病的狂妄症结果的影响.
- 在没有感染症状的情况下,评估抗生素对的持续时间和严重性的影响.
主要方法:
- 在PROSPERO注册的系统审查协议 (CRD42023418091).
- 在Medline和Embase数据库中搜索到2023年4月的相关研究.
- 包括老年人 (≥60岁) 的随机对照试验 (RCT) 和观察性研究,这些成年人患有炎症/细菌性尿症,但没有全身感染或泌尿生殖系统症状.
主要成果:
- 包括4项研究 (1项RCT,3项观察性) 涉及652名老年人 (平均年龄84.6岁).
- 没有一项研究表明抗生素对妄结果有显著的益处.
- 两项研究表明,抗生素使用可能会使妄想恶化.
结论:
- 没有证据支持使用抗生素改善老年人无症状细菌性尿症 / 皮尿症的 Delirium 结果.
- 现有的证据是有限的,主要是观测的,并且具有相当大的偏见风险.
- 需要进一步进行高质量的研究,以澄清抗生素在这种人群中的作用.
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