【摘要】 目的评估阿莫西林-克拉维酸(Amo/Clav)制剂治疗小儿急性呼吸道感染的临床有效性。方法计算机检索Medline(OvidSP)、EMBASE、Cochrane Central Register of Controlled Trials、中国生物医学文献数据库、万方数据资源系统、中国期刊全文数据库。收集从1985年1月至2011年12月关于阿莫西林-克拉维酸制剂治疗呼吸道感染的随机对照研究。采用RevMan5.1.4进行Meta分析,计数资料采用两个率的比值比(OR)及其95%CI表示。采用漏斗图评估可能存在的发表偏异。结果共检索到相关文献219篇,其中英文文献164篇,中文文献55篇。最终筛选出符合纳入标准的文献共27篇,其中以阿奇霉素为对照者20篇,以头孢克洛为对照者7篇;累计病例2971例,对照3057例。Amo/Clav制剂与阿奇霉素比较,上呼吸道感染文献Meta分析OR(95%CI)=1.34(1.02～1.76),统计量Z=2.08(P=0.04),而下呼吸道感染文献的Meta分析OR(95%CI)=1.31(0.56～3.09),Z=0.62(P=0.53)。Amo/Clav制剂与头孢克洛比较,OR(95%CI)=0.88(0.32～2.45),Z=0.24(P=0.81)。结论文献Meta分析提示,Amo/Clav制剂治疗小儿急性细菌性上呼吸道感染的临床疗效优于阿奇霉素,而治疗小儿急性细菌性下呼吸道感染的临床疗效两者相仿。Amo/Clav制剂与头孢克洛在治疗小儿急性细菌性呼吸道感染的临床疗效相仿。更多还原

【Abstract】 Objective To assess the clinical efficacy of amoxicillin-clavulanic acid ( Amo/Clav ) preparations for treatment of children with acute respiratory tract infections. Methods We performed computer-based retrieval of Medline( on OvidSP ), EMBASE , Cochrane Central Register of Controlled Trials , Chinese Bio-medicine Database ( CBM ), Wanfang Database System and China National Knowledge Infrastructure ( CNKI ) .Data of randomized controlled studies of amoxicillin-clavulanic acid preparations for treatment of respiratory tract infections from January 1985 to December 2011 was collected. RevMan5.1.4 Meta-analysis of count data and odds ratio ( OR ) with 95% confidence interval ( 95% CI ) were applied. Funnel plot was used to assess published deviation. Results We retrieved 219 literatures , of which 164 were in English and 55 in Chinese . Twenty-seven articles that met the inclusion criteria were chosen by final screening , including azithromycin contrast 20 and cefaclor 7 for control. The total cases were 2971 and in control groupthere were 3057 cases. Comparing Amo/Clav with azithromycin in upper respiratory tract infections literature Meta analysis , OR ( 95% CI ) = 1.34 ( 1.02 ～ 1.76 ),Z = 2.08 (P =0.04 ), while in lower respiratory infections literature Meta analysis ,OR ( 95 % CI ) = 1.31 ( 0.56 ～ 3.09 ),Z = 0.62 (P = 0.53 ) . Comparing Amo/Clav preparation with cefaclor , OR ( 95% CI ) = 0.88 ( 0.32 ～ 2.45 ),Z = 0.24 (P = 0.81 ) . Conclusion Literatures Meta-analysis indicates Amo/Clav treatment for children with acute bacterial upper respiratory infections is superior to azithromycin clinically , but in the treatment of children with acute bacterial lower respiratory tract infec tions , the clinical efficacy of both is similar. The Amo/ Clav and cefaclor have similar clinical efficacy in the treatment of children with acute bacterial respiratory in fections.更多还原