PDF(Pubmed)
Abstract：
UNASSIGNED: Some cohort studies have explored the effects and safety of polymyxin B (PMB) in comparison to other antibiotics for the treatment of nosocomial infections, yielding inconsistent results. This systematic review aims to explore the effectiveness and safety of PMB and compared it with other antibiotics.
UNASSIGNED: A systematic literature search was conducted in PubMed, Embase, the Cochrane Library, and Web of Science, searching specific terms to identify quantitative cohort studies or RCTs that compared the effects of PMB with other antibiotics in terms of their efficacy and safety. The Newcastle-Ottawa Scale (NOS) was conducted to evaluate the risk of bias of observational studies. Odds ratios with 95% confidence intervals were used for outcome assessment. We evaluated heterogeneity using the I 2 test.
UNASSIGNED: A total of 22 observational trials were included in the analysis. The PMB group had a higher mortality rate compared to the control group (odds ratio: 1.84, 95% CI: 1.36-2.50, p<0.00001, I 2 = 73%). while, the ceftazidime-avibactam group demonstrated a distinct advantage with lower mortality rates, despite still exhibiting high heterogeneity (odds ratio 2.73, 95% confidence interval 1.59-4.69; p = 0.0003; I 2 = 53%). Additionally, the PMB group had a lower nephrotoxicity rate compared to the colistin group but exhibited high heterogeneity in the results (odds ratio 0.58, 95% CI 0.36-0.93; p = 0.02; I 2 = 73%).
UNASSIGNED: In patients with nosocomial infections, PMB is not superior to other antibiotics in terms of mortality, specifically when compared to ceftazidime-avibactam. However, PMB demonstrated an advantage in terms of nephrotoxicity compared to colistin.
UNASSIGNED: A systematic literature search was conducted in PubMed, Embase, the Cochrane Library, and Web of Science, searching specific terms to identify quantitative cohort studies or RCTs that compared the effects of PMB with other antibiotics in terms of their efficacy and safety. The Newcastle-Ottawa Scale (NOS) was conducted to evaluate the risk of bias of observational studies. Odds ratios with 95% confidence intervals were used for outcome assessment. We evaluated heterogeneity using the I 2 test.
UNASSIGNED: A total of 22 observational trials were included in the analysis. The PMB group had a higher mortality rate compared to the control group (odds ratio: 1.84, 95% CI: 1.36-2.50, p<0.00001, I 2 = 73%). while, the ceftazidime-avibactam group demonstrated a distinct advantage with lower mortality rates, despite still exhibiting high heterogeneity (odds ratio 2.73, 95% confidence interval 1.59-4.69; p = 0.0003; I 2 = 53%). Additionally, the PMB group had a lower nephrotoxicity rate compared to the colistin group but exhibited high heterogeneity in the results (odds ratio 0.58, 95% CI 0.36-0.93; p = 0.02; I 2 = 73%).
UNASSIGNED: In patients with nosocomial infections, PMB is not superior to other antibiotics in terms of mortality, specifically when compared to ceftazidime-avibactam. However, PMB demonstrated an advantage in terms of nephrotoxicity compared to colistin.
摘要：
■一些队列研究探讨了多粘菌素B（PMB）与其他抗生素治疗医院感染的效果和安全性，产生不一致的结果。本系统评价旨在探讨PMB的有效性和安全性，并将其与其他抗生素进行比较。
■在PubMed进行了系统的文献检索，Embase,Cochrane图书馆,和WebofScience,搜索特定术语以确定定量队列研究或RCT,这些研究或RCT比较了PMB与其他抗生素的疗效和安全性.采用纽卡斯尔-渥太华量表（NOS）评估观察性研究偏倚的风险。使用95%置信区间的赔率比进行结果评估。我们使用I2检验评估异质性。
■共22项观察性试验纳入分析。与对照组相比，PMB组的死亡率更高（比值比：1.84，95％CI：1.36-2.50，p<0.00001，I2=73％）。while,头孢他啶-阿维巴坦组表现出明显的优势，死亡率较低，尽管仍表现出较高的异质性（比值比2.73，95％置信区间1.59-4.69；p=0.0003；I2=53％）。此外,与粘菌素组相比,PMB组的肾毒性率较低,但结果具有高度异质性(比值比0.58,95%CI0.36~0.93;p=0.02;I2=73%).
■在医院感染患者中，PMB在死亡率方面并不优于其他抗生素，特别是与头孢他啶-阿维巴坦相比。然而,与粘菌素相比，PMB在肾毒性方面表现出优势。
■在PubMed进行了系统的文献检索，Embase,Cochrane图书馆,和WebofScience,搜索特定术语以确定定量队列研究或RCT,这些研究或RCT比较了PMB与其他抗生素的疗效和安全性.采用纽卡斯尔-渥太华量表（NOS）评估观察性研究偏倚的风险。使用95%置信区间的赔率比进行结果评估。我们使用I2检验评估异质性。
■共22项观察性试验纳入分析。与对照组相比，PMB组的死亡率更高（比值比：1.84，95％CI：1.36-2.50，p<0.00001，I2=73％）。while,头孢他啶-阿维巴坦组表现出明显的优势，死亡率较低，尽管仍表现出较高的异质性（比值比2.73，95％置信区间1.59-4.69；p=0.0003；I2=53％）。此外,与粘菌素组相比,PMB组的肾毒性率较低,但结果具有高度异质性(比值比0.58,95%CI0.36~0.93;p=0.02;I2=73%).
■在医院感染患者中，PMB在死亡率方面并不优于其他抗生素，特别是与头孢他啶-阿维巴坦相比。然而,与粘菌素相比，PMB在肾毒性方面表现出优势。
