0.5%左氧氟沙星滴眼液治疗成人和儿童眼部细菌感染性疾病的有效性和安全性的系统评价

Systematic Review on Efficacy and Safety of 0.5%Levofloxacin Eye Drops in the Treatment of Ocular Bacterial Infectious Diseases in Adults and Children

目的:系统评价0.5%左氧氟沙星滴眼液在成人和儿童眼部细菌感染性疾病治疗中的有效性和安全性。方法:计算机检索PubMed、Embase、the Cochrane Library、ClinicalTrail.gov、中国知网、万方数据库及中国生物医学文献数据库,检索时间为建库至2020年4月,纳入0.5%左氧氟沙星滴眼液治疗成人和儿童眼部细菌感染性疾病的随机对照试验(研究组患者使用0.5%左氧氟沙星滴眼液,对照组患者使用其他阳性治疗药物),进行Meta分析。结果:0.5%左氧氟沙星滴眼液治疗成人睑腺炎的有效性和安全性优于0.3%左氧氟沙星滴眼液,但差异无统计学意义(P>0.05)。0.5%左氧氟沙星滴眼液治疗细菌性角膜炎的总有效率显著高于0.3%氧氟沙星滴眼液,差异有统计学意义(P<0.05);0.5%左氧氟沙星滴眼液治疗儿童细菌性结膜炎的总有效率以及治疗成人重症细菌性角膜炎和结膜炎的总有效率均高于0.3%氧氟沙星滴眼液,但差异无统计学意义(P>0.05)。0.5%左氧氟沙星滴眼液治疗成人细菌性结膜炎的效果优于0.3%诺氟沙星滴眼液,但差异无统计学意义(P>0.05)。0.5%左氧氟沙星滴眼液治疗成人细菌性结膜炎的总有效率不及0.3%加替沙星滴眼液,安全性结果的差异无统计学差异(P>0.05)。结论:与包括0.3%左氧氟沙星滴眼液、0.3%氧氟沙星滴眼液和0.3%诺氟沙星滴眼液在内的第3代氟喹诺酮类药物相比,0.5%左氧氟沙星滴眼液在治疗各类成人和儿童眼部细菌感染性疾病中的有效性相当甚至更优,但不及第4代氟喹诺酮类药物0.3%加替沙星滴眼液;药物整体安全性良好。

OBJECTIVE:To systematically review the efficacy and safety of 0.5%levofloxacin eye drops in the treatment of ocular bacterial infectious diseases in adults and children.METHOEDS:Randomized controlled trials on 0.5%levofloxacin eye drops in the treatment of ocular bacterial infectious diseases in adults and children(the research group was treated with 0.5%levofloxacin eye drops,while the control group was given other positive therapeutic agents)from base-building to Apr.2020 were retrieved from PubMed,Embase,the Cochrane Library,ClinicalTrail.gov,CNKI,Wanfang Data and CBM were retrieved for Meta-analysis.RESULTS:The effectiveness and safety of 0.5%levofloxacin eye drops in the treatment of hordeolum in adults were better than those of 0.3%levofloxacin eye drops,while the difference was not statistically significant(P>0.05).The total effective rate of 0.5%levofloxacin eye drops in the treatment of bacterial keratitis was significantly higher than that of 0.3%ofloxacin eye drops,with statistically significant difference(P<0.05);the total effective rates of 0.5%levofloxacin eye drops in the treatment of bacterial conjunctivitis in children and severe bacterial keratitis and conjunctivitis in adults were higher than those of 0.3%ofloxacin eye drops,while the difference was not statistically significant(P>0.05).The effectiveness of 0.5%levofloxacin eye drops in the treatment of bacterial conjunctivitis in adults was better than that of 0.3%norfloxacin eye drops,while the difference was not statistically significant(P>0.05).The total effective rate of 0.5%levofloxacin eye drops in the treatment of bacterial conjunctivitis in adults was inferior to that of 0.3%gatifloxacin eye drops,and the difference in safety outcomes was not statistically significant(P>0.05).CONCLUSIONS:Compared with the 3rd generation fluoroquinolones including 0.3%levofloxacin eye drops,0.3%ofloxacin eye drops and 0.3%of norfloxacin eye drops,0.5%levofloxacin eye drops has comparable or better effectiveness in the treatment of various types of ocular bacterial infectious diseases in adults and children,while it’s inferior to the 4th generation fluoroquinolones 0.3%of gatifloxacin eye drops;with good overall safety.