哌拉西林/他唑巴坦的改良输注方式治疗严重感染的系统评价  

A Systematic Review of Alternative and Traditional Infusion Regimen of Piperacillin/tazolbactam in the Treatment of Critically Infected Patients

作　　者：肖宇博[1] 李荣凌[1] 沈秉正[1] 李萌[1] 时晓晨 

机构地区：[1]武汉大学人民医院药学部,武汉430060 [2]武汉大学人民医院急诊科,武汉430060

出　　处：《药学与临床研究》2015年第5期456-461,共6页Pharmaceutical and Clinical Research

摘　　要：目的：通过meta分析比较哌拉西林/他唑巴坦（PTZ）改良输注（延长2-4 h或持续24 h输注）与传统输注（0.5-1 h输注）治疗严重感染患者的疗效及安全性。方法：在Medline、ScienceDirect、CNKI、VIP、万方数据库检索有关PTZ改良输注方式的临床研究，辅以手工检索。采用RevMan 5.0软件进行统计分析。结果：总共纳入15项临床研究。改良输注组死亡率明显低于传统输注组[RR=0.76，95% CI（0.63-0.92），P=0.004；I2=0%]，改良输注组有效率明显高于传统输注组[RR=1.11，95% CI（1.01-1.22），P=0.03；I2=53%]，而细菌清除率[RR=1.29，95% CI（0.76-2.21），P=0.35；I2=0%]及不良反应发生率[RR=1.22，95% CI（0.71-2.12），P=0.47；I2=0%]，两组均无明显差异。结论：延长或持续输注PTZ可以降低感染治疗的死亡风险、提高临床有效率。Objective: To evaluate the efficacy and safety of alternative (extended 2-4 h or continuous 24 h infusion) and traditional dosing application of piperacillin/tazolbactam in the treatment of critically in-fected patients. Methods: Published articles were searched in MEDLINE, ScienceDirect, CNKI, VIP, and Wanfang database, supplemented by manual searches, to identify all the RCT and non-RCT of clinical re-searches aiming to explore the advantages of alternative infusion regimen of piperacillin/tazolbactam. The data processing was done with the RevMan 5.0 software. Results: Fifteen studies were included. Comparing with the intermittent infusion group, the alternative infusion group showed significantly higher rates of clini-cal success [RR=1.11, 95% CI (1.01-1.22), P=0.03; I2=53%] and lower mortality [RR=0.76,95% CI (0.63-0.92), P=0.004; I2=0%], but no significant difference in the rates of bacteriologic eradication [RR=1.29, 95% CI (0.76-2.21), P=0.35; I2=0%] or incidence of adverse drug reactions [RR=1.22, 95% CI (0.71-2.12), P=0.47; I2=0%]. Conclusion: Our study suggests that extended continuous infusion of piperacillin/tazolbac-tam is associated with lower mortality risk and higher clinical success rates. There is no significant safety difference between the alternative and intermittent infusions.

关 键 词：哌拉西林/他唑巴坦 延长输注 持续输注 META分析 

分 类 号：R969.4[医药卫生—药理学]