Safety and clinical efficacy of linezolid in children:a systematic review and meta-analysis  

作　　者：Yi Shi Hai-Lan Wu Yu-Hang Wu Shuang Li Li-Ya Zhang Shan-Shan Xu He-Yu Huang Chun-Hong Zhang Xu-Ben Yu Kang Cai Jing Zhang Li-Su Huang 

机构地区：[1]Department of Infectious Disease,Xinhua Children’s Hospital,Xinhua Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200092,China [2]National Clinical Research Center for Child Health,Children’s Hospital,Zhejiang University School of Medicine,Hangzhou,310052,China [3]Institute of Antibiotics,Huashan Hospital,Fudan University,Shanghai,200040,China [4]Department of Pharmacy,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou,325000,China

出　　处：《World Journal of Pediatrics》2023年第2期129-138,共10页世界儿科杂志（英文版）

基　　金：National Natural Science Foundation of China(Nos.81874265,82073561);Shanghai Jiao Tong University School of Medicine(No.2020002);Shanghai Science and Technology Commission(Nos.18411966600,19410740800);Key Discipline Construction Plan from Shanghai Municipal Health Commission(No.GWV-10.1-XK01);National Ministry of Science and Technology-National Key R&D Program Project(No.2021YFE0201900);and National Respiratory Field Key Laboratory Emergency Project(No.EKPG21-08).

摘　　要：Background We aimed to evaluate the tolerability and efficacy of linezolid in children for treating suspected and diagnosed Gram-positive bacterial infections.Methods A systematic literature search was conducted up to April 23,2021,using linezolid and its synonyms as search terms.Two reviewers independently identified and extracted relevant randomized controlled trials and prospective cohort studies.The extracted studies were included in a single-rate meta-analysis of adverse events and clinical outcomes using random-effects models.Results A total of 1082 articles were identified,and nine studies involving 758 children were included in the meta-analysis.The overall proportion of adverse events was 8.91%[95%confidence interval(CI)=1.64%–36.52%],with diarrhea(2.24%),vomiting(2.05%),and rash(1.72%)being the most common.The incidences of thrombocytopenia and anemia were 0.68%and 0.16%,respectively.Some specific adverse events,including rash and gastrointestinal events,were more frequent in the oral administration subgroup.In terms of efficacy,the overall proportion of clinical improvement was 88.80%(95%CI=81.31%–93.52%).Children with a history of specific bacteriological diagnosis or concomitant antibiotic therapy had a 1.13-fold higher clinical improvement than children without such histories.The proportion of microbial eradication was 92.68%(95%CI=84.66%–96.68%).The proportion of all-cause mortality was 0.16%(95%CI=0.00%–7.75%).Conclusions Linezolid was well-tolerated in pediatric patients and was associated with a low frequency of adverse events,such as anemia,thrombocytopenia,and neutropenia.Moreover,linezolid was effective in children with diagnosed and suspected Gram-positive infections.

关 键 词：CHILDREN EFFICACY LINEZOLID META-ANALYSIS SAFETY 

分 类 号：R725.8[医药卫生—儿科]