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阿奇霉素治疗儿科呼吸道疾病的安全性特征和不良反应:系统评价和荟萃分析。

Safety profiles and adverse reactions of azithromycin in the treatment of pediatric respiratory diseases: A systematic review and meta-analysis.

机构信息

Department of Pediatrics, The People's Hospital of Fenghua, Ningbo City, Zhejiang Province, China.

出版信息

Medicine (Baltimore). 2023 Dec 1;102(48):e36306. doi: 10.1097/MD.0000000000036306.

Abstract

BACKGROUND

Azithromycin (AZM) is an antimicrobial agent and frequently used in the treatment of pediatric respiratory diseases due to its well-recognized clinical efficacy. Despite some favorable findings from many studies, there is a lack of research reports focusing on the safety profiles and adverse reactions.

METHODS

The randomized controlled trials of AZM in the treatment of pediatric respiratory diseases on internet databases were searched. The search databases included Chinese CNKI, Wanfang, VIP, PubMed, EMBASE, and Cochrane Library. Two researchers of this study independently assessed the eligibility, risk of bias, and extracted the data. The included literature was meta-analyzed and subgroup analyzed by revman 5.1 software.

RESULTS

A total of 14 eligible studies were included. The results of meta-analysis showed that the incidence of adverse reactions after AZM treatment was 24.20%, which was lower than 48.05% in the control group (OR = 0.42, 95% CI 0.12-0.72, P < .001). In the subgroup of sequential therapy, AZM had a lower incidence of adverse reactions in sequential therapy (OR = 0.29, 95% CI 0.09-0.60, P < .001). In the subgroup of intravenous administration, AZM had a lower the incidence of adverse reactions (OR = 0.57, 95% CI 0.12-0.84, P = .003). In the subgroup of oral administration, AZM had a lower the incidence of adverse reactions (OR = 0.45, 95% CI 0.13-0.69 P < .001). Overall, it was also found that the incidence of adverse reactions in the AZM subgroup was significantly lower than that in other treatment subgroup.

CONCLUSION

AZM has fewer adverse reactions and better safety profiles, which make AZM a more attractive option in the treatment of pediatric respiratory diseases.

摘要

背景

阿奇霉素(AZM)是一种抗菌药物,由于其公认的临床疗效,常用于治疗儿科呼吸道疾病。尽管许多研究都有一些有利的发现,但缺乏针对安全性概况和不良反应的研究报告。

方法

在互联网数据库中搜索 AZM 治疗儿科呼吸道疾病的随机对照试验。搜索数据库包括中国知网、万方、维普、PubMed、EMBASE 和 Cochrane 图书馆。本研究的两名研究人员独立评估了纳入标准、偏倚风险和提取数据。使用 RevMan 5.1 软件对纳入文献进行荟萃分析和亚组分析。

结果

共纳入 14 项合格研究。荟萃分析结果显示,AZM 治疗后不良反应发生率为 24.20%,低于对照组的 48.05%(OR=0.42,95%CI 0.12-0.72,P<0.001)。在序贯治疗亚组中,AZM 序贯治疗的不良反应发生率较低(OR=0.29,95%CI 0.09-0.60,P<0.001)。在静脉给药亚组中,AZM 的不良反应发生率较低(OR=0.57,95%CI 0.12-0.84,P=0.003)。在口服给药亚组中,AZM 的不良反应发生率较低(OR=0.45,95%CI 0.13-0.69,P<0.001)。总体而言,还发现 AZM 亚组的不良反应发生率明显低于其他治疗亚组。

结论

AZM 的不良反应较少,安全性较好,使其成为治疗儿科呼吸道疾病更具吸引力的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a965/10695561/df6740ddb45e/medi-102-e36306-g001.jpg

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