Antimicrobial therapy of Clostridium difficile infection Systematic literature review and meta-analysis

被引:2
作者
Brodszky, Valentin [1 ]
Gulacsi, Laszlo [1 ]
Ludwig, Endre [2 ]
Prinz, Gyula [3 ]
Banai, Janos [6 ]
Remenyi, Peter [4 ]
Strbak, Balint [1 ]
Kertesz, Adrienne [5 ]
Nemeth, Iren Kopcsone [7 ]
Urban, Edit Zsoldine [8 ]
Baji, Petra [1 ]
Pentek, Marta [1 ]
机构
[1] Budapesti Corvinus Egyet, Egeszseg Gazdasagtani & Egeszsegugyi Technol Elem, Budapest, Hungary
[2] Egyesitett Szent Istvan & Szent Laszlo Korhaz, Infektol Osztaly 7, Budapest, Hungary
[3] Egyesitett Szent Istvan & Szent Laszlo Korhaz, Infektol Osztaly 4, Budapest, Hungary
[4] Egyesitett Szent Istvan & Szent Laszlo Korhaz, Hematol & Ossejt Transzplantacios Osztaly, Budapest, Hungary
[5] Egyesitett Szent Istvan & Szent Laszlo Korhaz, Infekciokontroll Osztaly, Budapest, Hungary
[6] MH EK Honvedkorhaz, Gasztroenterol Osztaly, Budapest, Hungary
[7] MH EK Honvedkorhaz, Korhazhigieniai Osztaly, Budapest, Hungary
[8] Szegedi Tudomanyegyet, Altalanos Orvostudomanyi Kar, Klin Mikrobiol Diagnosztikai Tanszek, Szeged, Hungary
关键词
Clostridium difficile; meta-analysis; metronidazole; vancomycin; fidaxomicin; RANDOMIZED CONTROLLED-TRIAL; PSEUDOMEMBRANOUS COLITIS; ORAL VANCOMYCIN; FUSIDIC ACID; METRONIDAZOLE; DIARRHEA; SOCIETY; NITAZOXANIDE; TEICOPLANIN; GUIDELINES;
D O I
10.1556/OH.2013.29627
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Clostridium difficile is the leading cause of antibiotic associated infectious nosocomial diarrhoea. Limited number of new pharmaceutical products have been developed and registered in the past decades for the treatment of Clostridium difficile infection. The available scientific evidence is limited and hardly comparable. Aim: To analyse the clinical efficacy and safety of metronidazole, vancomycin and fidaxomicin in the therapy of Clostridium difficile infection. Methods: Systematic review and meta-analysis of the literature data. Results: Meta-analysis of literature data showed no significant difference between these antibiotics in clinical cure endpoint (odss ratios: fidaxomicin vs. vancomycin 1.19; vancomycin vs. metronidazol 1.69 and fidaxomicin vs. metronidazol 2.00). However, fidaxomicin therapy was significantly more effective than vancomicin and metronidazol in endpoints of recurrence and global cure (odds ratios: fidaxomicin vs. vancomycin 0.47; vancomycin vs. metronidazol 0.91 es fidaxomicin vs. metronidazol 0.43). There was no significant difference between fidaxomicin, vancomycin and metronidazole in safety endpoints. Conclusions: Each antibiotic similarly improved clinical cure. Fidaxomicin was the most effective therapeutic alternative in lowering the rate of recurrent Clostridium difficile infections.
引用
收藏
页码:890 / 899
页数:10
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