【摘要】 目的:评价持续输注β-内酰氨类抗生素的临床有效性和安全性。方法:计算机检索Cochrane图书馆临床对照试验资料库(2007年第4期)、MEDLINE(1966～2008.2)、EMBASE(1980～2008.2)和中国生物医学文献光盘数据库(1978～2008.2)。手工检索初步入选文献的全文和参考文献中所列相关文献。收集国内外比较持续和间断输注β-内酰氨类抗生素治疗重症感染患者的临床随机对照试验。由两名评价员独立选择试验和提取资料,对纳入文献进行方法学质量评价和定性、定量分析。结果:按照纳入标准和检索策略,最终检索到15篇相关文献。2篇属于高质量文献,其它13篇文献均存在不同程度的方法学缺陷。与间断给药方案相比,持续输注β-内酰氨类抗生素并不能改善患者的临床指标,但β-内酰氨类抗生素的特性和药动学原理方面,续输注给药方案明显优于间断给药方案。结论:持续输注β-内酰氨类抗生素是值得推广和进一步研究的给药方案。我们期待更多以药代学和药效学为基础的设计良好的随机对照试验来进一步优化抗生素给药方案。更多还原

【Abstract】 OBJECTIVE To assess the effectiveness and safety of continuous infusion of β-lactam antimicrobial for severely infectious patients.METHODS We searched Cochrane Register of Controlled Trials(Issue 4,2007),MEDLINE(1966 to February 2008),EMBASE(1980 to February 2008) and CBMdisc(1978 to February 2008),manually searched the references lists of relevant publications.We included randomized controlled trials(RCTs)comparing continuous infusion of β-lactam antimicrobial with intermittent dosing in severely infectious patients.Two reviewers assessed the methodological quality of each trial and extracted data independently.The dates were described quantitatively and qualitatively.RESULTS According to our inclusion standards and search strategies,there were 15 eligible trials into our systematic review.Two of them were high-quality trials.There were associated methodological limitations in the other trials.Clinical efficacy of continuous infusion of β-lactam antimicrobial did not vary significantly compared with intermittent dosing.But continuous infusion of β-lactams is superior to that with intermittent infusion in pharmacodynamic and pharmacokinetic.CONCLUSION The systematic review demonstrates many potential advantages to administration of β-lactams by continuous infusion.Further clinical trials are needed to clearly establish the benefits,as well as any disadvantages of continuous infusion of β-lactams over current intermittent dosing regiments.更多还原