头孢他啶阿维巴坦单药治疗与联合治疗碳青霉烯耐药肠杆菌感染的有效性及安全性的meta分析

Efficacy and Safety of Ceftazidime/Avibactam in Monotherapy or Combination Therapy Against Carbapenem Resistant Enterobacteriaceae: A Meta-analysis

目的系统评价头孢他啶阿维巴坦(ceftazidime/avibactam,CAZ/AVI)单药治疗与联合治疗碳青霉烯耐药肠杆菌(carbapenem resistant enterobacteriaceae,CRE)感染的有效性和安全性。方法计算机检索CNKI、Wanfang Data、CBM、PubMed、The Cochrane Library、Web of Science、Embase,检索时间为建库至2021年4月,查找CAZ/AVI单药治疗与联合治疗CRE感染的研究。对符合纳入条件的研究进行资料提取和质量评价后,采用RevMan 5.3统计软件进行meta分析。结果共纳入13项研究,合计1452例患者。Meta分析结果显示,CAZ/AVI单药治疗对比联合治疗CRE的病死率[RR=0.98,95%CI(0.82,1.17),P=0.82]、微生物清除率[RR=1.02,95%CI(0.8,1.28),P=0.89]、临床治愈率[RR=0.97,95%CI(0.83,1.13),P=0.66]差异无统计学意义。结论基于目前的研究结果,CAZ/AVI单药治疗与联合治疗CRE的疗效与安全性无显著差异,该结果尚需更多前瞻性研究以及随机对照研究的验证。

OBJECTIVE To evaluate the efficacy and safety of ceftazidime/avibactam(CAZ/AVI)in monotherapy or combination therapy against carbapenem resistant enterobacteriaceae(CRE)infection.METHODS CNKI,Wanfang Data,CBM,PubMed,The Cochrane Library,Web of Science and Embase were searched by computer from construction to April 2021.To investigate the study of CAZ/AVI monotherapy and combination therapy for CRE infection.After data extraction and quality assessment of the eligible studies,RevMan 5.3 statistical software was used for meta-analysis.RESULTS A total of 13 studies involving 1452 patients were included.The results of meta-analysis showed that compared with the combined treatment of CAZ/AVI,the mortality rate[RR=0.98,95%CI(0.82,1.17),P=0.82],microbial clearance rate[RR=1.02,95%CI(0.8,1.28),P=0.89]and the clinical cure rate[RR=0.97,95%CI(0.83,1.13),P=0.66]of monotherapy had no statistically significant.CONCLUSION Based on the current study results,there is no significant difference in the efficacy and safety of CAZ/AVI monotherapy and combination therapy for CRE,which needs to be verified by more prospective studies and randomized controlled studies.