Clin Chem Lab Med:降钙素原对上呼吸道感染抗生素使用及临床转归的影响

2017-07-25 MedSci MedSci原创

目前已有项试验发现降钙素原(PCT)有助于指导下呼吸道感染和脓毒症患者的抗生素治疗方案。本篇meta分析旨在于分析PCT是否对指导上呼吸道感染(URTI)患者的抗生素治疗方案有利。

目前已有数项试验发现降钙素原(PCT)有助于指导下呼吸道感染和脓毒症患者的抗生素治疗方案。本篇meta分析旨在于分析PCT是否对指导上呼吸道感染(URTI)患者的抗生素治疗方案有利。

使用PubMed(MEDLINE)和Cochrane对2016年9月前发表的相关研究文献进行检索。我们对临床诊断为上呼吸道感染成年患者的个体数据进行重新分析,以PRISMA-IPD作为指标对两组数据进行分析。主要可分析的结果为(1)治疗失败:死亡、住院、严重并发症、感染复发或恶化、持续使用抗生素大于28天;(2)使用抗生素14天的后细菌活动得到抑制。次要分析目标是开始抗生素治疗的时机和使用抗生素的总天数。

本分析总共包括644例随访了28天的已确诊上呼吸道感染的患者。在治疗失败的分析显示没有显着差异(33.1% vs 34%,OR 1.0,95% CI 0.7-1.4;P=0.896);细菌活性得到抑制的天数【8 vs 8天,OR 0.2(95% CI 0.4-0.9),P=0.465】。然而, PCT指导抗生素治疗组使用抗生素的总共时间(17.8% vs 51%,OR 0.2,95% CI 0.1-0.3;P<0.001)比与处方指导治疗组短2.4天(95% CI 2.9-1.9;P<0.001)。

因此我们可以得出结论:使用PCT指导抗生素治疗方案,与上呼吸道感染患者预后紧密相连,可明显减少使用抗生素总天数。


原始出处:

Odermatt J1, Friedli N1, et al. Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis. Clin Chem Lab Med. 2017 Jun 29. pii: /j/cclm.ahead-of-print/cclm-2017-0252/cclm-2017-0252.xml. doi: 10.1515/cclm-2017-0252.

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    2017-07-29 laoli

    谢谢分享,学习了

    0

  4. 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    2017-07-27 zhmscau
  6. 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25 18:46:17 CST 2017, time=2017-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=226221, encodeId=49712262215c, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=80d11516357, createdName=139****0239, createdTime=Tue Jul 25 18:27:45 CST 2017, time=2017-07-25, status=1, ipAttribution=)]
    2017-07-26 137****9095

    henhao

    0

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    2017-07-26 有备才能无患

    使用PCT指导抗生素治疗方案,与上呼吸道感染患者预后紧密相连,可明显减少使用抗生素总天数。

    0

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    2017-07-25 131****1460

    学习了受益匪浅。

    0

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