麦克罗利德和四环素与饮食干预的临床重要相互作用 - - 一项系统性综述与元分析
Agnieszka Wiesner1,2, Paweł Zagrodzki2, Alicja Gawalska3
1Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
The Journal of antimicrobial chemotherapy
|September 10, 2024
概括
饮食干预显著影响宏类和四环素类抗生素的吸收,影响疗效和安全性. 了解这些药物与食物的相互作用是最佳抗生素管理的关键.
科学领域:
- 药理学 药理学是指药理学的学科.
- 药物相互作用 药物相互作用
- 抗生素的生物可用性
背景情况:
- 药物与食品的相互作用极大地影响了抗生素的有效性和安全性.
- 对这些相互作用的管理对于患者的治疗结果至关重要.
- 麦克罗利德和四环素是被广泛使用的抗生素类别.
研究的目的:
- 系统地审查和评估饮食干预措施对类和四环素抗生素生物可用性的影响.
- 综合关于食物,饮料,抗酸剂和矿物质补充剂如何影响口服抗生素药理学的证据.
- 评估这些类抗生素药物与食品相互作用的证据质量.
主要方法:
- 按照PRISMA指南进行系统审查.
- 在Medline,Embase和Cochrane图书馆的数据库中搜索到2022年12月.
- 包括对口服宏类和四环素的研究,分析食品,饮料,抗酸药和矿物补充剂影响的药理学参数. 使用Cochrane和NIH工具评估偏差风险. 在可能的情况下进行定量元分析;否则进行定性合成.
主要成果:
- 包括120项研究 (97份报告);对8种宏类和4种四环素的元分析.
- 在77%的宏化物和86%的四环素中观察到显著的食物影响.
- 延长释放的阿齐思罗米辛和克拉里思罗米辛的生物可用性效应是积极的;对红色素,阿齐思罗米辛囊,德麦克洛环素和奥马达环素的负面影响. 抗酸药/矿物质降低了四环素的吸收;牛奶/葡萄汁显示出不同的效果.
结论:
- 抗生素与食物之间的相互作用是复杂的,受药物特性,配方和干预类型的影响.
- 由于研究的局限性 (过时,多样化的方法,数据缺口),证据质量较低.
- 需要进一步进行高质量的研究,以澄清特定的药物与食品相互作用概况.
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