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不同类别抗菌药物治疗住院成人CAP患者有效性与安全性的网状Meta分析
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| 篇名： | 不同类别抗菌药物治疗住院成人CAP患者有效性与安全性的网状Meta分析 |
| TITLE： | Efficacy and safety of different classes of antibacterial agents for hospitalized adult patients with community-acquired pneumonia：a network meta-analysis |
| 摘要： | 目的 比较不同类别抗菌药物治疗住院成人社区获得性肺炎（CAP）患者的疗效与安全性。方法检索PubMed、Embase、CochraneLibrary、WebofScience、中国知网及万方数据，收集不同类别抗菌药物治疗住院成人CAP的随机对照试验（RCT），检索时限为建库至2026年1月1日。筛选文献、提取数据并评价文献质量后，采用Stata18.0软件进行网状Meta分析。结果共纳入25项研究，共计7863例患者。在疗效方面，与使用碳青霉烯类抗菌药物比较，使用青霉素类抗菌药物、头孢菌素类抗菌药物、大环内酯类抗菌药物及截短侧耳素类抗菌药物患者的治疗失败率显著升高（P＜0.05），累积排序概率图下面积（SUCRA）排名前2位的为碳青霉烯类抗菌药物和传统四环素类抗菌药物。各干预措施间的死亡率比较，差异均无统计学意义（P＞0.05），SUCRA排名前2位的为碳青霉烯类抗菌药物和其他喹诺酮类抗菌药物。在安全性方面，各干预措施间的不良反应发生率、停药率比较，差异均无统计学意义（P＞0.05）；不良反应发生率SUCRA排名前2位为传统四环素类抗菌药物和新型四环素类抗菌药物，停药率SUCRA排名前2位为新型四环素类抗菌药物和截短侧耳素类抗菌药物。结论碳青霉烯类抗菌药物可显著降低住院成人CAP患者的治疗失败率；各抗菌药物的安全性相当，其中新型四环素类抗菌药物的安全性更好。 |
| ABSTRACT： | OBJECTIVE To compare the efficacy and safety of different classes of antibacterial agents in hospitalized adult patients with community-acquired pneumonia （CAP）.METHODS PubMed， Embase，the Cochrane Library，Web of Science，CNKI，and Wanfang data were searched from inception to January 1，2026，to identify randomized controlled trials that evaluated different classes of antibacterial agents in hospitalized adults with CAP.After screening the literature， extracting the data， and evaluating the quality of the literature， a network meta-analysis was performed using Stata 18.0.RESULTS A total of 25 studies were included，involving 7 863 patients. In terms of efficacy，compared with carbapenems，penicillins，cephalosporins，macrolides，and pleuromutilins were associated with significantly higher treatment failure rates （ P ＜0.05），carbapenems and traditional tetracyclines were ranked as the top two by the surface under the cumulative ranking curve area （SUCRA）. No statistically significant differences were observed in mortality among the interventions （ P ＞0.05），carbapenems and other quinolones were ranked as the top two by SUCRA. In terms of safety，no statistically significant differences were observed among the interventions in the incidence of adverse events or discontinuation rates （ P ＞0.05）；traditional tetracyclines and novel tetracyclines were ranked as the top two by SUCRA for the incidence of adverse events，while novel tetracyclines and pleuromutilins were ranked as the top two by SUCRA for discontinuation rates.CONCLUSIONS Carbapenems significantly reduced the treatment failure rate in hospitalized adults with CAP. The safety profiles of all antibacterial agents were comparable， with novel tetracyclines showing a more favorable safety profile. |
| 期刊： | 2026年第37卷第18期 |
| 作者： | 刘天琦；李瑞雪；赵紫楠；徐文峰；梁孜；张嘉瑜；李婷；金鹏飞 |
| AUTHORS： | LIU Tianqi，LI Ruixue，ZHAO Zinan，XU Wenfeng，LIANG Zi，ZHANG Jiayu，LI Ting，JIN Pengfei |
| 关键字： | 社区获得性肺炎;抗菌药物;不同类别;疗效;安全性 |
| KEYWORDS： | community-acquired pneumonia;Antibacterial agents;different classes;Efficacy;Safety |
| 阅读数： | 1 次 |
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