阿米卡星联合β-内酰胺类抗菌药物经验性治疗中性粒细胞缺乏并发热肿瘤患者的系统评价  

Amikacin Combined with β-lactam Antibiotics for Empirical Treatment of Febrile Neutropenic Patients with Cancer:A Systematic Review

作　　者：邓楠[1] 谭波宇[1] 陈丽[1] 韦鸿雁[1] 

机构地区：[1]湖南师范大学第一附属医院药学部,长沙410002

出　　处：《中国药房》2012年第28期2622-2626,共5页China Pharmacy

基　　金：湖南省财政厅;科技厅科技计划资助项目(2009FJ3055)

摘　　要：目的:系统评价阿米卡星联合β-内酰胺类抗菌药物经验性治疗中性粒细胞缺乏并发热(FN)肿瘤患者的有效性和安全性。方法:计算机全面检索Medline、EMBase、CENTRAL、EBSCOCINAHL、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP),辅以手工检索相关文献的参考文献,收集阿米卡星联合β-内酰胺类抗菌药物治疗FN肿瘤患者的临床随机对照试验(RCT)。结果:共纳入18项RCT,合计3074人次。Meta分析结果显示,单用组初始方案治疗成功率[RR=1.12,95%CI(1.04,1.20),P=0.003]、感染相关性死亡率[RR=0.52,95%CI(0.32,0.87),P=0.01]、治疗失败率[RR=0.88,95%CI(0.81,0.97),P=0.007]均优于联用组;2组二重感染发生率[RR=1.08,95%CI(0.69,1.71),P=0.73]、不良反应发生率[RR=1.08,95%C(I0.97,1.20),P=0.15]比较差异无统计学意义。结论:阿米卡星联合β-内酰胺类抗菌药物可作为初始FN肿瘤患者安全、有效的治疗方案。OBJECTIVE：To evaluate the effectiveness and safety of amikacin combined with β-lactam antibiotics for empirical treatment of febrile neutropenic（FN） patients with cancer.METHODS：Randomized controlled trials（RCT） about amikacin combined with β-lactam antibiotics for FN patients with cancer were retrieved from Medline,EMBase,CENTRAL,EBSCO CINAHL,CBM,CNKI and VIP.We also searched relevant journals by hand.RESULTS：18 RCT met the inclusion criteria,involving 3 074 episodes.Meta-analysis showed that the success rate [RR=1.12,95%CI（1.04,1.20）,P=0.003],infection-related mortality [RR=0.52,95%CI（0.32,0.87）,P=0.01] and the rate of treatment failure [RR=0.88,95%CI（0.81,0.97）,P=0.007] in the combination group were worse than in the monotherapy group.There was no statistical significance in the incidence of superinfection [RR=1.08,95%CI（0.69,1.71）,P=0.73] and ADR [RR=1.08,95%CI（0.97,1.20）,P=0.15] between 2 groups.CONCLUSION：Amikacin combined with β-lactam antibiotics is effective and safe as an initial treatment for FN patients with cancer.

关 键 词：阿米卡星 中性粒细胞缺乏 发热 META分析 

分 类 号：R969.3[医药卫生—药理学]