3 种喹诺酮类药治疗尿路感染效果的Meta 分析

Efficacy of three Quinolone antimicrobial agents in treatment of urinary tract infection: a meta-analysis of randomized controlled trials

摘要:

目的 系统评价莫西沙星与左氧氟沙星、加替沙星治疗尿路感染的临床疗效。方法 利用Cochrane Library、Pubmed、Embase、中国生物医学文献数据库、中国知网及万方数据库（自建库至2017 年2 月28 日） 检索符合要求的随机对照试验研究，按照Cochrane 风险偏倚评估工具评价纳入研究的方法学质量。运用Rev Man 5.3 软件计算合并效应及95%CI，并按照不同药物种类和给药方式进行分层分析。结果 共纳入8 篇符合标 准的文献（包括1 039 例研究对象），入选病例的治疗药物有莫西沙星、左氧氟沙星及加替沙星。Meta 分析显示， 莫西沙星治疗尿路感染的总有效率低于左氧氟沙星和加替沙星（P <0.05），但两组不良反应发生率比较，差异 无统计学意义（P >0.05）；分层分析显示，莫西沙星治疗尿路感染总有效率低于左氧氟沙星（P <0.05），而与 加替沙星比较，差异无统计学意义（P >0.05）。莫西沙星与左氧氟沙星、加替沙星通过口服给药治疗尿路感 染总有效率比较，差异有统计学意义（P <0.05）。结论 与左氧氟沙星、加替沙星相比，莫西沙星治疗尿路感 染的临床疗效并无优势。

Abstract:

Objective To systematically review the curative efficacy of Moxifloxacin, Levofloxacin, and Gatifloxacin in treatment of urinary tract infection. Methods Retrieve randomized controlled trials (RCTs) conformed to the inclusion and exclusion criteria in Cochrane Library, Pubmed, EMbase, Sinomed, CNKI and Wan Fang database were included in this study. Cochrane Collaboration was used to assess the quality of the included researches. Stratification analysis was performed based on factors as drug species and delivery methods. Results A total of 8 studies were eligible for analysis, including 1,039 study objects. Antibiotics included in studies were Moxifloxacin, Levofloxacin and Gatifloxacin. Data from Meta-analysis showed that total effective rate of Moxifloxacin were lower than the other two drugs (P < 0.05). No obvious difference in adverse effects rate was not identified among groups (P > 0.05). Data derived from the Hierarchical analysis showed that the total effective rate of Moxifloxacin was lower than that of Levofloxacin (P < 0.05) while no difference was founded between Moxifloxacin and Gatifloxacin (P > 0.05). Three antibiotics exerted different total effective rate (P < 0.05). Conclusions Moxifloxacin had no significant clinical advantages over Levofloxacin or Gatifloxacin.