夫西地酸钠治疗耐甲氧西林金黄色葡萄球菌感染的Meta分析

Meta analysis of sodium fusidiate in treatment of methicillin-resistant Staphylococcus aureus infections

目的系统评价夫西地酸钠治疗耐甲氧西林金黄色葡萄球菌(MRSA)的有效性和安全性。方法计算机检索2000年至2014年在Pub Med、Ovid全文数据库、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方等数据库公开发表的以万古霉素、替考拉宁、利奈唑胺为对照,研究夫西地酸钠治疗MRSA感染的随机对照研究。评价纳入的文献质量和提取有效数据后,采用Rev Man 5.2统计学软件进行Meta分析。结果共纳入6篇文献,1篇英文,5篇中文。Meta分析结果显示,试验组与对照组的临床有效率[RR=0.95,95%CI(0.90,1.00),P>0.05]、细菌清除率[RR=0.91,95%CI(0.82,1.01),P>0.05]及安全性[RR=0.83,95%CI(0.63,1.09),P>0.05]均无显著差异。夫西地酸钠的不良反应发生率显著小于万古霉素[RR=0.54,95%CI(0.31,0.95),P<0.05]。结论夫西地酸钠治疗MRSA感染安全有效,具有较高的临床应用价值。

AIM To evaluate the effect and safety of sodium fusidate in treatment of methicillin-resistant Staphylococcus aureus（ MRSA） infections. METHODS Papers about sodium fusidiate in treatment of MRSA infections with vancomycin, teicoplanin, and linezolid as control group, were searched in Pub Med, Ovid,CNKI, VIP, CBM, and Wanfang database from 2000 to 2014. The included papers were evaluated and effective data were extracted, the meta analysis was be done using Rev Man 5.2 statistical software. RESULTS A total of six documents, one in English, five in Chinese, included 481 cases of patients. Meta-analysis showed that the experimental group and the control group had no statistically difference in clinical efficacy（RR = 0.95,95%CI（0.90, 1.00）, P 〉 0.05）, bacterial clearance rate（ RR = 0.91, 95% CI（ 0.82, 1.01）, P 〉 0.05）and security（RR = 0.83, 95%CI（0.63, 1.09）, P 〉 0.05）. The adverse reaction rate of sodium fusidate was lower than that of vancomycin（ RR = 0.54, 95% CI（ 0.31, 0.95）, P 〈 0.05）. CONCLUSION Sodium fusidate is safe and effective in treatment of MRSA infections with a high clinical value.