与IV相比,在血流感染中过渡到口服治疗:系统性审查和元分析
Omme Salma1, Mohammed Abdul Samee1, Muhammad Saqlain Mustafa2
1Osmania Medical College, Hyderabad, Telangana, India.
Annals of medicine and surgery (2012)
|March 20, 2025
概括
早期口服抗生素治疗金黄色葡萄球菌感染可能会增加死亡风险,相比于IV治疗. 然而,这种方法并没有显著影响治疗失败,再住院或不良事件,因此需要进一步研究.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 黄金葡萄球菌 (Staphylococcus aureus) 血流感染是一个主要的公共卫生问题.
- 对这些感染的最佳抗微生物策略进行了讨论.
- 评估早期的口服过渡与持续的静脉注射治疗至关重要.
研究的目的:
- 系统地审查和元分析早期口服抗菌药物治疗的疗效和安全性与持续的静脉注射 (IV) 治疗.
- 为了比较患有甲素耐药黄金葡萄球菌 (MRSA) 和甲素敏感黄金葡萄球菌 (MSSA) 血流感染的患者的结果.
主要方法:
- 以PRISMA为指导的系统审查和元分析.
- 在PubMed,Embase,Scopus和Web of Science数据库中进行了搜索 (2003年8月 - 2024年6月).
- 包括11项研究,共54至220名参与者.
主要成果:
- 早期口服治疗组与持续静脉注射治疗组相比,观察到全因死亡风险增加71.6% (RR: 1.716; 95% CI: 1.039-2.836; P = 0.035).
- 两组之间没有发现治疗失败,再住院率,不良事件或住院时间的显著差异.
- 分析包括了主要是男性参与者的研究,年龄在30年代中期到70年代初.
结论:
- 与长期静脉注射治疗相比,S. aureus血流感染的早期口服抗菌药物治疗与死亡风险显著增加有关.
- 这种方法没有增加不良事件或再住院率,这表明潜在的安全性.
- 需要进一步的随机对照试验来证实这些发现,并制定最终的治疗指南.
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