替加环素治疗鲍曼不动杆菌感染的Meta分析

Efficacy of tigecycline to Acinetobacter baumannii: Systematic review with Meta-analysis

目的运用Meta分析方法评价替加环素治疗鲍曼不动杆菌感染的有效性、细菌清除率及不良反应。方法检索中文、英文数据库及医学网站，收集有关替加环素治疗鲍曼不动杆菌感染的临床试验文献，制定纳入排除标准，使用ReviewManager5-3、Statal3软件进行Meta分析。结果最终纳入30篇文献，单用替加环素与其它抗菌药物在总体有效率和细菌清除率方面的对比中，无统计学差异（P〉0．05）。替加环素联合使用在总体有效率方面明显优于其他抗菌药物（OR=4．24，95％CI3．17-5．68，P〈0．01），在总体细菌清除率方面也明显优于其他抗菌药物（OR=2．94，95％CI2．29～3．78，P〈0．01）。单用替加环素和替加环素联合使用在有效率方面的对比中，替加环素联合使用优于单用替加环素（OR=0．54，95％C10．31-0．93，P=0．03），而在细菌清除率方面，两者相比无统计学差异（P〉0．05）。替加环素组（单用和联合用药）与其它抗菌药物在不良反应方面的对比中，无统计学差异伊〉0．05）。结论替加环素联合用药治疗鲍曼不动杆菌引起的感染性疾病的效果优于单用替加环素组和其它抗菌药物组，安全性较好。

Objective To evaluate the efficacy, bacteriologic success and adverse reactions of tigecycline to treat Acinetobacter baumannii infections by Meta-analysis method. Methods Literatures about tigecycline in the therapy of Acinetobacter baumannii infectious diseases published before were retrieved from the Chinese database, English database and Medical website, the articles were screened by the inclusion criteria, Meta-analysis was performed by the statistical software Review Manager 5.3 and Statal3. Results 30 studies were identified, the analysis showed that there was no statistically significant difference in the total efficacy and the bacteriologic success between tigecycline alone groups and other antibacterial drugs groups（P〉0.05）. Tigecycline combination groups were significantly superior than other antibacterial drugs groups in the total efficacy（OR=4.24, 95%CI 3.17-5.68, P〈0.01）. Tigecycline combination groups were significantly superior than other antibacterial drugs groups in the total bacteriologic success（OR=2.94, 95%CI 2.29-3.78, P〈0.01）. There was statistically difference in the efficacy between tigecycline alone and tigecycline combination groups（OR=0.54, 95%CI 0.31-0.93, P=-0.03）, but dose not have statistically significant difference in the bacteriologic success（P〉0.05）. The analysis showed that there was no statistically significant difference in the adverse reaction between tigecycline groups（tigecycline alone and tigecycline combination） and other antibacterial drugs groups（P〉0.05）. Conclusion Tigecycline combination groups had better effect against Acinetobacter baumannii than tigecycline alone and other antibacterial drugs groups. It could improve the efficacy and could not have more significant adverse reaction.