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头孢他啶阿维巴坦与黏菌素/多黏菌素B治疗碳青霉烯耐药革兰阴性杆菌感染的有效性和安全性比较系统评价
Efficacy and safety comparison of ceftazidime avibactam versus colistin/polymyxin B in the treatment of carbapenem-resistant Gram-negative bacilli infection: a systematic review
【摘要】 目的:系统评价头孢他啶阿维巴坦(ceftazidime/avibactam, CAZ/AVI)与黏菌素/多黏菌素B治疗碳青霉烯耐药的革兰阴性杆菌感染的有效性和安全性。方法:检索Cochrane library、PubMed、Embase、中国知网及万方数据库等,收集CAZ/AVI与黏菌素/多黏菌素B治疗碳青霉烯耐药革兰阴性杆菌感染的随机对照研究或队列研究。检索时限为各数据库建库起至2022年5月。筛选文献、提取资料后,采用NOS量表评价文献的质量。结果:最终纳入7篇文献,共801例患者。Meta分析表明:CAZ/AVI组的死亡率和肾损伤发生率均低于黏菌素/多黏菌素B组(P<0.005),而临床治愈率和细菌清除率均高于黏菌素/多黏菌素B组(P<0.005)。结论:CAZ/AVI在治疗碳青霉烯耐药革兰阴性杆菌感染的临床有效性和安全性与对照组相比,显示出更好的疗效和更低的肾损伤发生率。
【Abstract】 Objective: To systematic review the efficacy and safety of ceftazidime avibactam(CAZ/AVI) and colistin/polymyxin B in the treatment of carbapenem-resistant Gram-negative bacilli infection. Methods: Cochrane Library, PubMed, Embase, CNKI and Wanfang data were searched to collect randomized controlled or cohort studies of ceftazidime avibactam and colistin/polymyxin B in the treatment of carbapenem-resistant Gram-negative bacilli infection. The retrieval time was from the establishment of each database to May 2022. After literature screening and data extraction, NOS was used to evaluate the quality of literature. Results: Totally 7 studies were finally enrolled, with a total of 801 patients. The results of Meta-analysis showed that the mortality rate and incidence of kidney injury in CAZ/AVI group were lower than those in colistin/polymyxin B group(P<0.005), while the clinical cure rate and bacterial clearance rate were higher than those in colistin/polymyxin B group(P<0.005). Conclusion: The clinical efficacy and safety of CAZ/AVI in the treatment of carbapenem-resistant Gram-negative bacilli infection showed better efficacy and lower incidence of kidney injury compared with the control group.
【Key words】 ceftazidime avibactam; colistin; polymyxin B; carbapenem resistance; efficacy; safety;
- 【文献出处】 中国新药杂志 ,Chinese Journal of New Drugs , 编辑部邮箱 ,2023年07期
- 【分类号】R446.5
- 【下载频次】73