静脉与静脉/口服抗生素治疗小儿穿孔性阑尾炎：系统评价和荟萃分析。,BMC Pediatrics

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静脉与静脉/口服抗生素治疗小儿穿孔性阑尾炎：系统评价和荟萃分析。
BMC Pediatrics ( IF 2.0 ) Pub Date : 2019-11-04 , DOI: 10.1186/s12887-019-1799-6
Chuan Wang ₁ , Yanan Li ₁ , Yi Ji ₁

Affiliation

背景技术为了避免静脉内药物的并发症并降低成本，建议在一定的静脉内（IV）抗生素疗程后使用口服（PO）抗生素。但是，序贯IV / PO抗生素的疗效和安全性尚不清楚，需要进一步研究。方法检索包括PubMed，EMBASE和Cochrane库在内的数据库。筛选了比较接受序贯IV / PO和PO抗生素治疗的穿孔性阑尾炎患者结局的研究。纽卡斯尔-渥太华量表（NOS）和Jadad评分分别用于评估队列和随机对照部分的质量。使用I2值评估统计异质性。根据I2值应用固定或随机效应模型。结果评估了五项对照研究，包括580例患者。汇总的评估显示，序贯的IV / PO抗生素治疗不会增加并发症的风险，术后脓肿的风险比（RR）为0.97（95％CI 0.51-1.83，P = 0.93），1.04（95％CI 0.25） -4.36，P = 0.96）（伤口感染）和0.62（95％CI 0.33-1.16，P = 0.13）。结论我们的研究表明，就术后脓肿，伤口感染和再入院而言，序贯的IV / PO抗生素治疗不逊于IV抗生素治疗。96）用于伤口感染，0.62（95％CI 0.33-1.16，P = 0.13）用于再入院。结论我们的研究表明，就术后脓肿，伤口感染和再入院而言，序贯的IV / PO抗生素治疗不逊于IV抗生素治疗。96）用于伤口感染，0.62（95％CI 0.33-1.16，P = 0.13）用于再入院。结论我们的研究表明，就术后脓肿，伤口感染和再入院而言，序贯的IV / PO抗生素治疗不逊于IV抗生素治疗。

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Intravenous versus intravenous/oral antibiotics for perforated appendicitis in pediatric patients: a systematic review and meta-analysis.

BACKGROUND The use of oral (PO) antibiotics following a course of certain intravenous (IV) antibiotics is proposed in order to avoid the complications of IV medications and to decrease the cost. However, the efficacy and safety of sequential IV/PO antibiotics is unclear and requires further study. METHODS The databases, including PubMed, EMBASE and Cochrane Library, were searched. Studies comparing outcomes in patients with perforated appendicitis receiving sequential IV/PO and PO antibiotics therapy were screened. The Newcastle-Ottawa Scale (NOS) and the Jadad score were used to evaluate the quality of the cohort and the randomized controlled portions of the trial, respectively. Statistical heterogeneity was assessed using the I2 value. A fixed or random-effect model was applied according to the I2 value. RESULTS Five controlled studies including a total of 580 patients were evaluated. The pooled estimates revealed that sequential IV/PO antibiotic therapy did not increase the risk of complications, with a risk ratio (RR) of 0.97 (95% CI 0.51-1.83, P = 0.93) for postoperative abscess, 1.04 (95% CI 0.25-4.36, P = 0.96) for wound infection and 0.62 (95% CI 0.33-1.16, P = 0.13) for readmission. CONCLUSIONS Our study demonstrates that sequential IV/PO antibiotic therapy is noninferior to IV antibiotic therapy regarding postoperative abscess, wound infection and readmission.

更新日期：2019-11-04

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