Systematic Review of Risk of Superinfection Induced by Carbapenems

WU Peifeng; HUANG Qiuling; HUANG Sufang; GAN Huizhen

doi:10.14009/j.issn.1672-2124.2021.08.019

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Systematic Review of Risk of Superinfection Induced by Carbapenems

更新时间：2022-10-08

- Systematic Review of Risk of Superinfection Induced by Carbapenems
- Vol. 21, Issue 8, Pages: 978-980(2021)
- 作者机构：
  
  中国人民解放军联勤保障部队第九一〇医院药剂科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2021.08.019
  CLC： R969
- Published：2021，
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WU Peifeng, HUANG Qiuling, HUANG Sufang, et al. Systematic Review of Risk of Superinfection Induced by Carbapenems. [J]. 21(8):978-980(2021)
DOI：

WU Peifeng, HUANG Qiuling, HUANG Sufang, et al. Systematic Review of Risk of Superinfection Induced by Carbapenems. [J]. 21(8):978-980(2021) DOI： 10.14009/j.issn.1672-2124.2021.08.019.

摘要

目的:系统评价碳青霉烯类抗菌药物致二重感染的风险。方法:在PubMed、Embase、the Cochrane Library和中国知网等数据库中检索碳青霉烯类抗菌药物对比非碳青霉烯类抗菌药物治疗感染的临床随机对照试验(randomized controlled trial

RCT)

检索时间为从建库至2020年10月。文献检索、数据提取和偏倚评价过程由2名研究者独立实施

选用Rev Man 5.3软件进行荟萃分析(Meta分析)。结果:共纳入9篇文献

包括886例患者。其中1篇中文文献

8篇英文文献; 6篇为亚胺培南西司他丁钠对比非碳青霉烯类抗菌药物的研究

3篇为美罗培南对比非碳青霉烯类抗菌药物的研究。Meta分析结果显示

碳青霉烯类抗菌药物致二重感染的风险显著高于非碳青霉烯类抗菌药物

差异有统计学意义(RR=1.52

95%CI=1.14～2.04

P=0.005);其中

亚胺培南西司他丁钠致二重感染的风险显著高于非碳青霉烯类抗菌药物

差异有统计学意义(RR=1.73

95%CI=1.26～2.37

P=0.000 7);美罗培南与非碳青霉烯类抗菌药物致二重感染的风险比较

差异无统计学意义(RR=0.70

95%CI=0.31～1.61

P=0.41)。结论:碳青霉烯类抗菌药物致二重感染的风险高于非碳青霉烯类抗菌药物

提示临床应用该类高级广谱抗菌药物时应更加谨慎

并注意二重感染的防治。

Abstract

OBJECTIVE: To systematically evaluate the risk of superinfection induced by carbapenems.METHODS: Pub Med

EMBase

the Cochrane Library and CNKI were retrieved to collect randomized controlled trial of carbapenems and non-carbapenems in the treatment of infections. The retrieval time was from the establishment of the database to Oct. 2020. Meta-analysis was performed by using Rev Man 5. 3 software after selection of literature

extraction of data and evaluation of risk of bias by two researchers. RESULTS: Totally 9 literature were collected

including 886 patients. There were one Chinese literature and eight English literature; six were literature with comparison of imipenem cistatin sodium and non-carbapenems

and three were literature with comparison of meropenem and non-carbapenems. Meta-analysis results showed that the risk of superinfection induced by carbapenems was significantly higher than that of non-carbapenems

and the difference was statistically significant（ RR = 1. 52

95%CI = 1. 14-2. 04

P = 0. 005）. The risk of superinfection induced by imipenem and cilastatin sodium was significantly higher than that of non-carbapenems（ RR = 1. 73

95% CI = 1. 26-2. 37

P = 0. 000 7）. There was no significant difference in the risk of superinfection between meropenem and non-carbapenems（ RR = 0. 70

95% CI =0. 31-1. 61

P = 0. 41）. CONCLUSIONS: The risk of superinfection induced by carbapenems is higher than that of noncarbapenems

suggesting that more caution should be exercised in the clinical application of these advanced broadspectrum antibiotics and attention should be paid to the prevention and treatment of superinfection.

关键词

美罗培南亚胺培南西司他丁钠碳青霉烯类抗菌药物Meta分析二重感染随机对照试验

Keywords

MeropenemImipenem cistatin sodiumCarbapenemsMeta-analysisSuperinfectionRandomized controlled trial

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