哌拉西林/三唑巴坦与碳青霉烯类初始经验性治疗粒细胞缺失伴发热有效性及安全性的Meta分析  

Meta-analysis of efficacy and safety of piperacillin-tazobactam versus carbapenems in the initial empirical therapy of febrile neutropenia

作　　者：游翔 王航[1] 黄品芳[1] 王长连[1] You Xiang;Wang Hang;Huang Pin-fang;Wang Chang-lian(The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005)

机构地区：[1]福建医科大学附属第一医院临床药学室,福州350005

出　　处：《中国抗生素杂志》2020年第2期192-198,共7页Chinese Journal of Antibiotics

摘　　要：目的 评价哌拉西林/三唑巴坦(piperacillin/tazobactam, PZ)与碳青霉烯类经验性治疗粒细胞缺乏伴发热(febrile neutropenia, FN)的有效性与安全性,为临床合理用药提供循证依据。方法 根据Cochrane指南,检索PubMed、EMBASE、The Cochrane Library、中国知网、维普数据库及万方数据库中关于PZ与碳青霉烯类用于治疗粒细胞缺乏伴发热的有效性与安全性的随机对照试验(randomized controlled trial, RCT)文献报道。使用RevMan5.3软件进行Meta分析,比较PZ与碳青霉烯类在治疗FN上的有效性与安全性差异。结果 纳入了6篇文献,共1159例次患者。Meta分析结果显示哌拉西林/三唑巴坦与碳青霉烯类在治疗成功率上无差异(P<0.05),但有着更低的不良反应发生率(95%CI:0.44~0.94, P=0.02)。结论 哌拉西林/三唑巴坦可代替碳青霉烯类作为经验性治疗粒细胞缺乏伴发热的首选药物。Objective To evaluate the efficacy and safety of piperacillin-tazobactam(PZ)and carbapenems in the empirical treatment of febrile neutropenia(FN),and provide evidence-based basis for the clinical treatment.Methods According to the Cochrane Guide,we searched PubMed,EMBASE,the Cochrane Library,CNKI,VIP database,and Wangfang database for the literature of randomized controlled trial(RCT)about the efficacy and safety of PZ and carbapenems in the treatment of agranulocytosis with fever.We used Software RevMan5.3 to perform the Meta-analysis of the included randomized controlled trials to distinguish the effect and safety of PZ and carbapenems in the empirical treatment of FN.Results Six literatures were included,involving 1,159 patients.Our research showed that piperacillin-tazobactam was similar to carbapenems in the treatment success rate(P<0.05),but had lower incidence of adverse reactions(95%CI:0.44~0.94,P=0.02).Conclusion PZ could be an excellent candidate for replacing carbapenems in the treatment of FN.

关 键 词：粒细胞缺乏伴发热 哌拉西林/三唑巴坦 碳青霉烯类 META分析 

分 类 号：R978[医药卫生—药品]