卡泊芬净在儿童侵袭性真菌感染中应用的有效性和安全性的系统评价和Meta分析

Efficacy and safety of caspofungin on invasive fungal infections in pediatric patients:A systematic review and meta-analysis

目的系统评价卡泊芬净在患儿中应用的有效性与安全性。方法检索The Cochrane Library、Pub Med、Em Base、中国知网、万方数据库和中国生物医学文献数据库,纳入有关儿童使用卡泊芬净治疗侵袭性真菌感染的随机对照试验(RCT)。检索时间截至2018年7月。用Rev Man 5. 3软件对整体有效性和安全性进行Meta分析。结果共纳入3项RCT分析,包括202例患儿,其中试验组(卡泊芬净) 124例,对照组(两性霉素B) 78例。Meta分析结果显示,试验组和对照组的有效率分别为68. 55%(85例/124例)和55. 84%(43例/77例),不良事件发生率分别为15. 45%(19例/123例)和12. 99%(10例/77例),差异均无统计学意义(均P> 0. 05)。结论卡泊芬净在儿童患者中应用的有效性和安全性不劣于两性霉素B。

Objective To systematically review the efficacy and safety of caspofungin in pediatric patients.Methods Multiple databases such as the Cochrane Library,PubMed,EmBase were searched electronically for randomized controlled trials(RCTs)of echinocandins to invasive candidiasis in pediatric patients up to July 2018.Two reviewers independently screened literatures according to the inclusion and exclusion criteria,extracted data,and assessed the methodological quality of the included studies.Then Meta-analysis was performed about RCTs of children who were treated for invasive fungal infections with caspofungin.Rev Man 5.3 software was used to analyze the overall effectiveness and safety.Results A total of 3 RCTs involving 202 patients were included.There were 124 patients in the treatment group and 78 patients in the control group.Caspofungin was retrieved in the treatment group.Amphotericin B was used to treat the patient in control group.The results of Meta-analysis showed that there were no significant difference between treatment group and control group on efficacy[68.55%(85 cases/124 cases)vs.55.84%(43 cases/77 cases),P>0.05]and safety(15.45%(19 cases/123 cases)vs.12.99%(10 cases/77 cases),P>0.05)Conclusion According to recent analysis,caspofungin has no inferior to amphotericin B in pediatric children.