小儿急性呼吸道感染阿莫西林-克拉维酸制剂临床疗效Meta分析  

Meta-analysis of the clinical efficacy of amoxicillin-clavulanic acid formulations for acute respiratory infections in children

作　　者：陆权[1] 罗剑锋[2] 车大钿[1] 董晓艳[1] 张嵬[3] 

机构地区：[1]上海交通大学附属儿童医院呼吸科,上海200040 [2]复旦大学公共卫生学院,卫生统计与社会医学教研室,上海200032 [3]复旦大学图书馆参考咨询部,上海200032

出　　处：《中国实用儿科杂志》2012年第12期915-921,共7页Chinese Journal of Practical Pediatrics

摘　　要：目的评估阿莫西林-克拉维酸(Amo/Clav)制剂治疗小儿急性呼吸道感染的临床有效性。方法计算机检索Medline(OvidSP)、EMBASE、Cochrane Central Register of Controlled Trials、中国生物医学文献数据库、万方数据资源系统、中国期刊全文数据库。收集从1985年1月至2011年12月关于阿莫西林-克拉维酸制剂治疗呼吸道感染的随机对照研究。采用RevMan5.1.4进行Meta分析,计数资料采用两个率的比值比(OR)及其95%CI表示。采用漏斗图评估可能存在的发表偏异。结果共检索到相关文献219篇,其中英文文献164篇,中文文献55篇。最终筛选出符合纳入标准的文献共27篇,其中以阿奇霉素为对照者20篇,以头孢克洛为对照者7篇;累计病例2971例,对照3057例。Amo/Clav制剂与阿奇霉素比较,上呼吸道感染文献Meta分析OR(95%CI)=1.34(1.02～1.76),统计量Z=2.08(P=0.04),而下呼吸道感染文献的Meta分析OR(95%CI)=1.31(0.56～3.09),Z=0.62(P=0.53)。Amo/Clav制剂与头孢克洛比较,OR(95%CI)=0.88(0.32～2.45),Z=0.24(P=0.81)。结论文献Meta分析提示,Amo/Clav制剂治疗小儿急性细菌性上呼吸道感染的临床疗效优于阿奇霉素,而治疗小儿急性细菌性下呼吸道感染的临床疗效两者相仿。Amo/Clav制剂与头孢克洛在治疗小儿急性细菌性呼吸道感染的临床疗效相仿。Objective To assess the clinical efficacy of amoxicillin-clavulanic acid （Amo/Clav）preparations for treatment of children with acute respiratory tract infections. Methods We performed computer-based retrieval of Medline （on OvidSP）, EMBASE, Cochrane Central Register of Controlled Trials, Chinese Bio-mediciue Database （CBM）, Wan- fang Database System and China National Knowledge Infrastructure （CNKI）.Data of randomized controlled studies of amoxicillin-clavulanic acid preparations for treatment of respiratory tract infections from January 1985 to December 2011 was collected. RevMan5.1.4 Meta-analysis of count data and odds ratio （OR）with 95% confidence interval （95% CI） were applied. Funnel plot was used to assess published deviation. Results We retrieved 219 literatures, of which 164 were in English and 55 in Chinese . Twenty-seven articles that met the inclusion criteria were chosen by final screening, including azithromycin contrast 20 and cefaelor 7 for control The total cases were 2971 and in control group there were 3057 cases. Comparing Amo/Clav with azithromycin in upper respiratory tract infections literature Meta analy- sis, OR （95% CI）= 1.34 （1.02 - 1.76）, Z = 2.08 （P=O.04）, while in lower respiratory infections literature Meta analysis, OR （95 % CI） = 1.31 （0.56 - 3.09）, Z = 0.62 （P = 0.53 ）. Comparing Amo/Clav preparation with cefaclor, OR （95% CI） = 0.88（0.32 - 2.45） ,Z = 0.24（P = 0.81 ）. Conclusion Literatures Meta-analysis indicates Amo/Clav treatment for chil- dren with acute bacterial upper respiratory infections is superior to azithromycin clinically, but in the treatment of chil-dren with acute bacterial lower respiratory tract infec- tions, the clinical efficacy of both is similar. The Amo/ Clay and cefaclor have similar clinical efficacy in the treatment of.children with acute bacterial respiratory in- fections.

关 键 词：阿莫西林-克拉维酸 临床疗效 META分析 急性呼吸道感染 儿童 

分 类 号：R72[医药卫生—儿科]