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Lancet infect dis:败血症患者延长β内酰胺类药物输液时间与治疗效果关系研究

2017-10-26 qinqiyun MedSci原创

关于延长β-内酰胺类药物输液时间的效果的随机对照试验(RCT)、观察性研究和Meta分析结果大不相同。现研究人员在败血症患者人群中,对比抗铜绿假单胞菌的β内酰胺类药物延长输液和短期输液的效果。

延长β-内酰胺类药物输液时间的效果,随机对照试验(RCT)、观察性研究和Meta分析结果大不相同。现研究人员在败血症患者人群中,对比抗铜绿假单胞菌的β内酰胺类药物延长输液和短期输液的效果。

研究人员从PubMed、Scopus和临床试验的Cochrane图书馆检索2016年11月前发表的文献进行系统回顾和Meta分析。纳入标准:随机对照试验、败血症患者、对比抗铜绿假单胞菌β内酰胺类药物延长输液(持续或≥3小时)和短期输液(≤60分钟)的临床疗效或死亡率。排除标准:非随机对照试验、患者人数不超过10例、无临床疗效和死亡率的相关数据等。主要评估指标:在任一时间点所有原因引起的死亡。

初筛2196篇文章,22个研究(1876位患者)纳入分析。涉及的抗生素有碳青霉烯、青霉素和头孢菌素。与短时间输液相比,延长抗生素输注时间可降低所有原因的死亡率(危险比[RR]0.70,95% CI 0.56-0.87)。未观察到异质性(p=0.93,I2=0%)。

治疗败血症患者,延长抗铜绿假单胞菌的β内酰胺类药物的输注时间,与短时间输液相比,可显着降低死亡率。

原始出处:

Konstantinos Z Vardakas,et al.Prolonged versus short-term intravenous infusion of antipseudomonal β-lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials.The Lancet Infectious Disease.October 25,2017.http://dx.doi.org/10.1016/S1473-3099(17)30615-1

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