头孢哌酮舒巴坦联合替加环素治疗多重耐药/泛耐药鲍曼不动杆菌肺炎的Meta分析  

Cefperazone sulbactam combined with Tigecycline in the treatment of pneumonia caused by multi-drug resistant/pan-resistant Acinetobacter baumannii:Meta-analysis

作　　者：马敬[1] 张涛[1] 马珂 MA Jing;ZHANG Tao;MA Ke(Department of Surgery Intensive Care Unit,Shanghai East Hospital of Tongji University, Shanghai 200123,China;Department of Laboratory Medicine ,the First Maternity and Infant Hospital of Tongji University)

机构地区：[1]同济大学附属东方医院外科监护室,上海200123 [2]同济大学附属第一妇婴保健院检验科

出　　处：《西北国防医学杂志》2019年第6期371-377,共7页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:评价头孢哌酮舒巴坦联合替加环素在多重耐药/泛耐药鲍曼不动杆菌(multi-drug resistant/pan-resistant Acinetobacter baumannii,MDRAB/XDRAB)肺炎治疗中的疗效,为MDRAB/XDRAB肺炎的抗生素治疗提供循证学依据。方法:制定原始文献的纳入标准及检索策略,计算机检索中国知网、维普中文科技期刊全文数据库、万方医学数据库,提取有关抗生素治疗MDRAB/XDRAB肺炎的对照研究文献。其中实验组采用替加环素联合头孢哌酮舒巴坦进行治疗,对照组采用其他两种抗生素联合(其中一种为替加环素或头孢哌酮舒巴坦)疗法。评价纳入研究的文献质量,提取有效数据后采用RevMan 5.3 软件进行Meta分析。结果:本研究共纳入12篇中文文献,研究对象739例,其中实验组364例,对照组375例。Meta分析显示,实验组治愈率为61.50%,明显高于对照组的38.67%;实验组总有效率为88.74%,明显高于对照组的68.53%;实验组痰菌转阴率为71.63%,明显高于对照组的49.65%(均 P <0.01);实验组不良反应发生率为13.04%,对照组为10.87%,差异无统计学意义( P >0.05)。结论:头孢哌酮舒巴坦联合替加环素治疗MDRAB/XDRAB肺炎临床疗效较好,建议进一步推广使用。Objective: To evaluate the efficacy of cefperazone sulbactam combined with tigecycline in the treatment of pneumonia caused by multi-drug resistant/pan-resistant Acinetobacter baumannii(MDRAB/XDRAB),and to provide evidence-based evidence for antibiotic treatment of MDRAB/XDRAB pneumonia. Methods: The control literature about MDRAB/XDRAB pneumonia treated with antibiotic were collected by searching China HowNet ,Wanfang Medical Database,Weipu Chinese Science and Technology Journal Full Text Database.The experimental group was treated with tigecycline combined with cefperazone sulbactam ,while the control group was treated with two other antibiotics combined (one of them was tigecycline or cefperazone sulbactam).The quality of the literature included were selected ,and valid data was extracted,and then analyzed with the RevMan 5.3 software. Results: A total of 739 subjects were included in 12 Chinese literatures,including 364 in the experiment group and 375 in the control group.The Meta-analysis showed that,the cure rate,total effective rate and the negative conversion rate of sputum to bacteria in the experiment group were higher than those in the control group(61.50% vs 38.67%, 88.74% vs 68.53%,71.63% vs 49.65%),the differences were statistically significant( P <0.01).The adverse reaction in the experiment group was 13.04% and the control groups was 10.87%,the difference was not statistically significant( P >0.05). Conclusion: Cefperazone sulbactam combined with tigecycline is recommended as a priority in the treatment of MDRAB/XDRAB pneumonia.

关 键 词：替加环素 头孢哌酮舒巴坦 多重耐药/泛耐药鲍曼不动杆菌 肺炎 META分析 

分 类 号：R969[医药卫生—药理学]