查詢結果分析
相關文獻
- 預防性抗生素與COPD風險之相關性
- 腹直肌鞘血腫合併慢性阻塞性肺病: 病例報告
- Lung Volume Reduction Surgery--A Case Report
- 巨環類抗生素Clarithromycin與Azithromycin
- Ariflo[fef0]--A Brief Report on a New Second-Generation Phosphodiesterase 4 Inhibitor
- Acute Chronic Respiratory Failure Complicated by Undetected Obstructive Sleep Apnea Syndrome
- 護理一位慢性阻塞性肺病個案之經驗
- 慢性阻塞性肺病的復健工作
- A Multidisciplinary Pulmonary Rehabilitation Program for Patients with Moderately Severe Chronic Obstructive Pulmonary Disease
- Agrobacterium Radiobacter Bacteremia in a Patient with Chronic Obstructive Pulmonary Disease
頁籤選單縮合
題 名 | 預防性抗生素與COPD風險之相關性=Prophylactic Use of Macrolide or Fluoroquinolone Therapy for the Prevention of Chronic Obstructive Pulmonary Disease Exacerbations |
---|---|
作 者 | 花逸茗; 李美娟; 吳佳璇; 蘇慧真; | 書刊名 | 藥學雜誌 |
卷 期 | 32:3=128 2016.09[民105.09] |
頁 次 | 頁40-48 |
分類號 | 418.281 |
關鍵詞 | 慢性阻塞性肺病; 巨環類抗生素; Chronic obstructive pulmonary disease; Macrolide; Fluoroquinolone; Exacerbation; |
語 文 | 中文(Chinese) |
中文摘要 | 2014年 Global Initiative for Chronic Obstructive Lung Disease (GOLD) 治療指引提 出針對預防慢性阻塞性肺病 (Chronic Obstructive Pulmonary Disease, COPD) 惡化的新 方針,其中 azithromycin 已被證實可有效減少惡化次數,而 moxifloxacin 具有針對呼 吸道穿透力佳和抗菌範圍廣的特性,可能對於預防氣管發炎有好處,近年來有三篇整 合分析討論此議題,皆認為使用巨環類抗生素可能有預防再次惡化的好處,且在之後 仍陸續有相關文獻發表,因此為了確認巨環類與 fluoroquinolone 抗生素療效、用法與 副作用,將利用實證醫學手法進行系統性文獻回顧及統合分析,以助於將來於臨床上 使用的正確性。 針對 PUBMED 和考科藍進行系統性文獻回顧,以 Jadad Sore 評核文章品質,利 用 Rew Man 5.3進行統合分析,異質性部分則以敏感性分析與次分組分析進一步探 討,研究結果以 Risk Ratio (RR) 與95%信賴區間呈現。總共收錄11篇隨機對照試驗, 分析結果發現使用抗生素可減少27%COPD 患者發生惡化之風險 (RR = 0.73; 95%CI = 0.60-0.89; I2 = 70%),次分組分析結果發現 erythromycin 可顯著減少 COPD 之惡化, 雖然使用抗生素出現副作用的風險比對照組高出19%,但無統計上差異 (RR = 1.19; 95%CI = 0.86-1.66)。 統合分析結果發現長期使用預防性抗生素可能有減少 COPD 惡化次數的好處,其 中以 erythromycin 與 azithromycin 效果較顯著,而副作用並未顯著高於對照組。 |
英文摘要 | In 2014, Global Initiative for Chronic Obstructive Lung Disease had developed new guideline recommended that the addition of azithromycin to standard COPD therapy could prevent exacerbations. And Moxifloxacin is demonstrated to be benefical in preventing bronchitis due to its excellent tissue penetration. Recently, three meta-analysis reinforced the effect that macrolide may prevent COPD exacerbation. However, more studies are reported but lack of detail information, such as regimen, duration, and side effects. Therefore, the purpose of this study is to evaluate the overall consensus about favoring prophylactic macrolides and fluoroquinolone for prevention of COPD exacerbation by Evidence-Based Medicine skill. Cochrane and Pubmed database were searched for relevant randomized controlled trials. The quality of article was evaluated by using of Jadad score. Rew Man 5.3 was used to analyze data, and subgroup analysis and sensitivity analysis were used to assess the heterogeneity. Results were presented by risk ratio and 95% confidence interval. Totally 11 RCTs were recruited. We found that utilization of antibiotics could reducing the risk of COPD exacerbation by 27% (RR = 0.73; 95%CI = 0.60-0.89; I2 = 70%). The result of subgroup analysis showed that erythromycin had significant effect on reducing the risk of COPD exacerbation. Although the risk of side effect in antibiotic group was higher than placebo but not of significance (RR = 1.19; 95%CI = 0.86-1.66). Long-term use of prophylactic macrolide could decrease the risk of COPD exacerbations, especially erythromycin and azithromycin. And the incidence of common adverse effects were not significantly different from placebo. |
本系統中英文摘要資訊取自各篇刊載內容。