头孢曲松单次治疗儿童急性中耳炎疗效和安全性的Meta分析

详细信息    查看全文 | 推荐本文 |

英文篇名：Efficacy and safety of single intramuscular dose of ceftriaxone in treating acute otitis media in children: a meta analysis 作者：姚莉莉 ; 徐锦龙 英文作者：YAO Li-li;XU Jin-long;Fuming Street Community Health Service Center of Yinzhou Ningbo;Pharmacy,The Second Hospital of Yinzhu Ningbo; 关键词：头孢曲松 ; 阿莫西林 ; 儿童 ; 急性中耳炎 ; Meta分析 英文关键词：ceftriaxone;;amoxicillin;;children;;acute otitis media;;Meta analysis 中文刊名：HZYG 英文刊名：Health Research 机构：宁波市鄞州区福明街道社区卫生服务中心;宁波市鄞州区第二医院药剂科; 出版日期：2019-02-25 16:48 出版单位：健康研究 年：2019 期：v.39;No.184 语种：中文; 页：HZYG201901019 页数：4 CN：01 ISSN：33-1359/R 分类号：76-79

摘要

目的评价头孢曲松单次治疗儿童急性中耳炎的疗效和安全性,为临床应用提供证据。方法检索头孢曲松单次治疗与阿莫西林口服治疗儿童急性中耳炎对比的随机对照研究(randomized controlled trial,RCTs),2位研究者独立进行文献筛选、关键数据提取并对纳入研究进行质量评价,而后行Meta分析。结果纳入4项研究,共502例患者。头孢曲松单次治疗与阿莫西林口服治疗相比,其治愈率(P=0. 33)、有效率(P=0. 73)、药品不良反应发生率(P=0. 84)均相当,而显效率明显较高(P=0. 0007)。结论从本次系统评价来看,头孢曲松单次治疗儿童急性中耳炎疗效略优于阿莫西林口服治疗。
        Objective To evaluate the efficacy and safety of ceftriaxone in the treatment of acute otitis media in children,and to provide evidence for clinical application. Methods The randomized controlled trial( RCTs) on single-dose ceftriaxone and oral amoxicillin for the treatment of acute otitis media in children were firstly collected. Secondly,two researchers independently screened literature,extracted key data,and evaluated the quality of the included studies,followed by Meta-analysis. Results A total of 502 patients were chosen as the subjects of four studies. There were no significant difference in the curative ratio( P = 0. 33),the effective rate( P = 0. 73) and the incidence of adverse drug reactions( P = 0.84) of the single-dose ceftriaxone treatment and the oral amoxicillin treatment. However,the excellence rate of the single-dose ceftriaxone treatment was higher than that of the oral amoxicillin treatment( P = 0. 0007).Conclusions The study indicated that the single-dose ceftriaxone is slightly better than amoxicillin in the treatment of acute otitis media in children.

引文

[1]张驰,吴玮,顾建文,等.大气污染与儿童急性中耳炎、急性扁桃体炎就诊人数的相关性调查[J].解放军预防医学杂志,2017,35(3):218-221.
    [2]中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会.儿童急性中耳炎诊疗---临床实践指南(2015年)[J].中国实用儿科杂志,2016,31(2):81-84.
    [3]Allan SL,Aaron EC,Tasnee C,et al.The diagnosis and management of acute otitis media[J].Pediatrics,2013,131(3):e964-999.
    [4]Teele DW,Klein JO,Rosner B.Epidemiology of otitis media during the first seven years of life in children in greater Boston:a pro-spective,cohort study[J].J Infect Dis,1989,160(1):83-94.
    [5]Richard MR,Jennifer JS,Seth RS,et al.Clinical practice guideline:otitis media with effusion[J].Otolaryngol head and neck surgery,2016,154(1 suppl):S1-S41.
    [6]Gudnason T,Gudbrandsson F,Barsanti F,et al.Penetration of ceftriaxone into the middle ear fluid of children[J].Pediatr Infect Dis J,1998,17:258-260.
    [7]Varsano I,Frydman M,Amir J,et al.Single intramuscular dose of ceftriaxone as compared to 7-day amoxicillin therapy for acuteotitis media in children.A double-blind clinical trial[J].Chemotherapy,1988,34(Suppl1):39-46.
    [8]李丽,李春梅.阿莫西林和头孢曲松治疗儿童急性中耳炎的疗效对比[J].中国保健营养:上旬刊,2014,24(5):2840-2841.
    [9]陈利华,王鼎盛.头孢曲松与阿莫西林治疗儿童急性中耳炎的成本-效果分析[J].中国全科医学,2005,8(13):1088-1089.
    [10]彭复运,徐徽.头孢曲松和阿莫西林用于儿童急性中耳炎治疗的对比分析[J].医学信息,2013,26(9):369-370.
    [11]肖敏.头孢曲松与阿莫西林用于儿童急性中耳炎治疗对比观察[J].医学信息,2013,26(7):205.
    [12]张亚梅,董频,陆培.头孢曲松与阿莫西林治疗儿童急性中耳炎的疗效比较研究[J].中华儿科杂志,2003,41(2):135-138.
    [13]王旭.头孢曲松治疗儿童急性中耳炎的临床价值分析[J].中外医疗,2014,34(11):115-116.
    [14]张志平,谢日林.小儿急性中耳炎早期采用头孢曲松钠治疗体会[J].临床医药实践,2016,43(5):355-356.