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利奈唑胺与万古霉素治疗儿童耐甲氧西林金葡菌感染疗效的Meta分析

杨南竹,吴玉秋,贠相华   

  1. 天津市第一医院
  • 收稿日期:2011-06-20 修回日期:2011-10-03 出版日期:2012-05-15 发布日期:2012-05-15
  • 通讯作者: 杨南竹

Linezolid versus vancomycin in the treatment of children with MRSA infections：Meta-analysis of randomised controlled trials

  • Received:2011-06-20 Revised:2011-10-03 Published:2012-05-15 Online:2012-05-15

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摘要： 摘要：目的 采用Meta分析方法评价利奈唑胺和万古霉素治疗儿童MRSA感染的的疗效及安全性。方法 计算机检索Medline、EMBASE、Ovid、CNKI及万方数据库。筛选符合纳入标准的文献并进行Meta分析。比较利奈唑胺和万古霉素治疗儿童MRSA感染的治愈率和不良反应发生率。结果 共纳入3个随机对照试验，包括588例MRSA感染的患儿。利奈唑胺组的临床治愈率89.72%优于万古霉素组85.71%，但差异无统计学意义[RR值为1.05,95% CI (0.98,1.12)，Z=1.49，P=0.14]；利奈唑胺临床治疗儿童MRSA感染的不良反应事件发生率分别为0.17%（70/399），低于万古霉素组0.40%（68/189），差异有统计学意义[RR值为0.49,95% CI (0.37,0.65),Z=4.93，P <0.00001]，利奈唑胺安全性优于万古霉素。结论 在治疗儿童MRSA感染中，利奈唑胺疗效相当于万古霉素。安全性优于万古霉素。

关键词: 　利奈唑胺, 万古霉素, 耐甲氧西林金葡菌, Meta分析

Abstract: Abstract Objective: A meta-analysis of randomized controlled trials on the efficacy and safety in children with MRSA infections treated with linezolid versus with vancomycin. Methods: The data were collected from the Medline database, and Chinese CNKI Database and the references of eligible studies were manually screened. Randomized controlled trials published in the English and Chinese literature comparing linezolid with vancomycin in children with MRSA infections were eligible for inclusion. Heterogeneity was examined by Chi-square test. Fixed effects model or random effects model were used to pool the data. Sensitivity analyses were used in the treatment course. Results: Three randomized controlled studies comparing linezolid with vancomycin were analyzed, focusing on the 588 children with MRSA infections. It was found by meta-analysis that, with respect to clinical treatment success, linezolid was as effective as vancomycin [89.72% vs. 85.71%, RR=1.05, 95% CI (0.98, 1.12), Z=1.49，P =0.14]. In the analysis with safety set, Significantly fewer linezolid-treated patients experienced drug-related adverse events than did vancomycin-treated patients [(0.17%vs. 0.40%,RR=0.49,95% CI (0.37,0. 65),Z=4.93，P <0.00001].Conclusion：Linezolid is as effective as vancomycin and more safety for treatment of patients with children infections caused by MRSA, although rigorously designed large sample size randomized double blind clinical trials are required to further demonstrate and support the conclusion.

Key words: Linezolid, Vancomycin, methicillin sensitive Staphylococcus aureus, Meta-analysis