摘要
目的系统评价降钙素原(PCT)指导重症加强治疗病房(ICU)严重感染的抗生素应用。方法应用Meta分析方法,对检索并入选的5篇相关随机对照试验(RCT)进行综合定量分析。结果共纳入927例患者,Meta分析结果显示:与对照组相比,PCT组缩短抗生素使用周期(MD=-2.01,95%CI(-2.37,-1.64),P<0.00001),而死亡率[OR=1.11,95%CI(0.83,1.49),P=0.47]及ICU治疗天数[MD=0.49,95%CI(-1.44,2.42),P=0.62]无显著差异。结论 PCT指导ICU严重感染的抗生素治疗能有效减少抗生素的应用,并且是安全的。
Objective To evaluate systematically the effectiveness and safety of procalcitonin(PCT)-guided therapy in comparison with standard therapy in patients with suspected or confirmed severe bacterial infections in intensive care unit(ICU).Methods Five randomized controlled trials(927 patients) were included for statistical analysis by the cochrane collaboration′s RevMan 5.0 software.Results PCT-guided therapy was associated with a significant reduction in duration of antibiotic therapy [MD=-2.01,95% CI(-2.37,-1.64),P<0.00001],but the mortality [OR=1.11,95%CI(0.83,1.49),P=0.47] and length of ICU stay[MD=0.49,95%CI(-1.44,2.42),P=0.62] were not significantly different.Conclusions An algorithm based on serial PCT measurements would allow a more judicious use of antibiotics than currently traditional treatment of patients with severe infections in ICU.It can reduce the use of antibiotics and appears to be safe.
出处
《中国呼吸与危重监护杂志》
CAS
2011年第2期176-180,共5页
Chinese Journal of Respiratory and Critical Care Medicine
