抗菌药物治疗伤寒综合征的网状Meta分析

Network meta-analysis of antibacterial drugs for the treatment of typhoidal syndrome

目的系统评价抗菌药物治疗伤寒综合征的临床疗效和安全性,从而得到安全有效的治疗方案。方法计算机检索Cochrane library、PubMed和EMbase等电子数据库,检索时间为2010年1月至2020年8月,根据本研究标准筛选随机对照试验,并将其纳入分析。使用累积概率排序曲线下面积来计算每种处理的排名。结果最终纳入17项随机对照实验(randomized controlled trial,RCT)的2793例患者,涉及抗菌药物13种。根据网状Meta分析结果,临床疗效方面,头孢他啶治疗失败率最低;安全性方面,莫西沙星治疗不良反应发生率最低。结论现有证据表明,头孢他啶治疗伤寒综合征效果最好,莫西沙星更安全。但受纳入文献数量和质量的限制,需要将这些结果与实际的长期有效性和安全性一起考虑,为临床应用提供依据。

Objective To investigate the reasonable antibacterial drugs for typhoidal syndrome patients by assessing the efficacy and safety through the way of network meta-analysis.Methods Data from various databases including Cochrane Library,PubMed,and EMBASE were retrieved from January 2010 to August 2020,and randomized controlled trials(RCTs)were screened by our criteria and included in the network meta-analysis.Surface under cumulative ranking curve result was used to calculate the ranking of each treatment.Results Finally,2793 patients in 17 RCTs were included,involving 13 kinds of antibacterial drugs.According to the results of network analysis,ceftazidime was ranked the lowest in treatment failure rate.On the other hand,moxifloxacin was ranked the lowest in adverse effects rate.Conclusion The existing evidence showed that,ceftazidime was considered to be the best among all the treatments in terms of efficacy for typhoidal syndrome patients,and moxifloxacin was indicated as the safest drugs.However,due to the limitation of the quantity and quality of the included literature,these results need to be considered alongside the real-world,long-term safety and effectiveness data of clinical application.