阿奇霉素与红霉素治疗呼吸道支原体感染疗效及安全性Meta分析  

Efficacy and safety of Azithromycin and Erythromycin for respiratory mycoplasma infection in children: a meta-analysis

作　　者：庞军[1,3] 金玉[1,2] 马彬[1] 杨克虎[1] 陈婧[1,3] 

机构地区：[1]兰州大学循证医学中心,兰州大学基础医学院,甘肃730000 [2]南京医科大学附属南京儿童医院,南京210000 [3]兰州大学第一临床学院,甘肃730000

出　　处：《中国实用儿科杂志》2012年第10期777-781,共5页Chinese Journal of Practical Pediatrics

摘　　要：目的评价口服阿奇霉素与口服及静脉应用红霉素治疗小儿呼吸道支原体感染的疗效和安全性。方法检索PubMed、Embase、Cochrane图书馆、CNKI、VIPH和万方数据库,检索时间截止至2012年2月。纳入有关阿奇霉素与红霉素治疗小儿呼吸道支原体感染的RCT试验。根据Cochrane Handbook 5.0.2质量评价标准评价纳入研究质量。采用RevMan5.0软件对数据进行定量合并。结果最终纳入4项RCT,其中3项研究阿奇霉素口服与红霉素口服,1项研究为比较阿奇霉素口服与红霉素静滴。共纳入患儿538例(阿奇霉素口服组319例,对照组219例)。Meta分析结果显示,对于呼吸道支原体感染患儿,临床疗效:阿奇霉素口服组≤15d及≥1个月疗效均优于红霉素口服组,阿奇霉素口服组与红霉素静滴组≤15d疗效差异均无统计学意义(P>0.05)。副反应:阿奇霉素口服组相对于红霉素口服及静滴组均较少出现腹泻和呕吐副反应(OR=0.22,95%CI:0.11～0.43;OR=0.23,95%CI:0.12～0.42)。结论阿奇霉素口服组≤15d和≥1个月疗效均优于红霉素口服组,同时与红霉素静滴组≤15d疗效无明显差异。阿奇口服组相对于红霉素口服及静滴组均较少出现腹泻及呕吐副反应。Objective To study the efficacy and safety of Azithromycin and that of Erythromycin for respiratory Mycoplasma infection in children. Methods All RCTs about Azithromycin and Erythromycin for Mycoplasma pneumonia were searched in PubMed, Embase, Cochrane Library, CNKI, VIPH, Wanfang database, etc, until Feb, 2012. We included the RCTs that compared Azithromycin with other medicine in the treatment of respiratory Mycoplasma infection in children.The quality evalutions were under the Cochrane Handbook 5.0.2, and the data were combined quantitatively by RevMan 5.0 software. Results There were 4 RCTs concluded. Three researches were to compare ＂Azithromycin oral VS Erythromycin oral＂. One research was to compare ＂Azithromycin oral VS Erythromycin ivgtt＂. Totally 538 children, Azithromycin oral group 319, control group 219. The Meta-analysis results showed that the clinical response conditions were as follows： the clinical response of ＂Azithromycin oral group＂ was better than ＂Erythromycin oral group＂ during the period ≤ 15 days or ≥ 1 month, there being no statistical difference between ＂Azithromycin oral group＂ and ＂Erythromycin ivgtt group＂ during the period ≤ 15 days after the treatment. Adverse effects： compared with ＂Erythromycin oral＇and ＂Erythromycin ivgtt＂ group, the children in the ＂Azithromycin oral＇group suffered less diarrhea and/or vomiting after the treatment （OR = 0.22,95%Ch0.11 - 0.43; OR = 0.23, 95%Ch0.12 ~ 0.42）. Conclusion In the treatment of respiratory Mycoplasma infection in children, the clinical effect of oral Azithromycin is better than that of oral Erythromycin during the period ≤ 15 days or ≥ 1 month, while the former effect is of no statistical difference from Erythromycin ivgtt. Adverse reactions： compared to erythromycin oral or ivgtt, the patients in Azithromycin oral group tend to have less diarrhoea and/or vomiting. All in all, Azithromycin is a goodchoice for the treatment of respiratory Mycoplasma infection in children.

关 键 词：呼吸道支原体感染 阿奇霉素 红霉素 儿童 META分析 

分 类 号：R72[医药卫生—儿科]