比阿培南与美罗培南治疗细菌性感染疗效和安全性的系统评价

目的系统评价比阿培南对比美罗培南治疗细菌性感染的有效性和安全性。方法计算机检索Ovid EMBase、Pubmed、Cochrane Library、CNKI、CBM、VIP和WanFang Data,对纳入研究进行筛选,提取数据和评价偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入11个RCTs,包括1873例患者。Meta分析结果显示:在临床总有效率[OR=1.55,95%CI(1.13,2.13),P=0.007],细菌清除率[OR=1.65,95%CI(1.15,2.38),P=0.007]和总体不良反应发生率[OR=0.67,95%CI(0.48,0.92),P=0.01]方面,比阿培南优于美罗培南,差异均具有统计学意义;但两组临床痊愈率[OR=1.24,95%CI(1.00,1.52),P=0.05]和不良事件发生率[OR=0.58,95%CI(0.29,1.16),P=0.13]无明显差异。漏斗图提示无明显发表偏倚。结论基于现有临床证据,与美罗培南相比,比阿培南能有效治疗细菌性感染,降低总体不良反应的发生,安全性更好。

The efficacy and safety of biapenem versus meropenem in treatment of bacterial infections: A systematic review

Objective To systematically evaluate the efficacy and safety of biapenem and meropenem in patients with bacterial infections. Methods Databases of Ovid EMBase, Pubmed, Cochrane Library, CNKI, CBM, VIP, and WanFang were searched. Each included study was screened, data extracted and methodological quality assessed, then analyzed by Rev Man 5.3 software. Results A total of 11 RCTs involving 1873 patients were included. Meta-analysis showed that biapenem was superior to meropenem in total effective rate [OR=1.55, 95%CI (1.13, 2.13), P=0.007], rate of bacterial clearance [OR=1.65, 95%CI(1.15, 2.38), P=0.007], and incidence of adverse drug reaction [OR=0.67, 95%CI(0.48, 0.92), P=0.01]. There were no statistically significant differences in cure rate [OR=1.24, 95%CI(1.00, 1.52), P=0.05] and incidence of adverse events [OR=0.58, 95%CI(0.29, 1.16), P=0.13] between two groups. The funnel plot showed no significant publication bias. Conclusion Based on the existing clinical evidence, biapenem can effectively treat bacterial infections and reduce the overall incidence of adverse drug reactions compared to