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学科主题: 临床医学
题名:
Efficacy and safety of daptomycin for the treatment of infectious disease: a meta-analysis based on randomized controlled trials
作者: He, Wenqiang; Zhang, Yawei; Chen, Hongbin; Zhao, Chunjiang; Wang, Hui
关键词: CPK elevation ; renal impairment ; lipopeptides
刊名: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
发表日期: 2014-12-01
DOI: 10.1093/jac/dku277
卷: 69, 期:12, 页:3181-3189
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Infectious Diseases ; Microbiology ; Pharmacology & Pharmacy
研究领域[WOS]: Infectious Diseases ; Microbiology ; Pharmacology & Pharmacy
关键词[WOS]: STAPHYLOCOCCUS-AUREUS BACTEREMIA ; SKIN-STRUCTURE INFECTIONS ; MINIMUM INHIBITORY CONCENTRATION ; SOFT-TISSUE INFECTIONS ; COMPLICATED SKIN ; STANDARD THERAPY ; COMPARING DAPTOMYCIN ; CLINICAL-OUTCOMES ; ENDOCARDITIS ; VANCOMYCIN
英文摘要:

A systematic review and meta-analysis based on randomized controlled trials (RCTs) of the efficacy and safety of daptomycin versus comparators.

Electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials and clinical registered trials) were searched to identify RCTs that assessed the efficacy and safety of daptomycin versus therapy with comparators. Two reviewers independently applied selection criteria, performed a quality assessment and extracted the data. The I-2 statistic was calculated for heterogeneity, and a random-effects or fixed-effects model was used for estimates of risk ratio (RR). The primary outcome assessed was clinical treatment success among the intention-to-treat (ITT) population.

Thirteen trials fulfilled the inclusion criteria. Daptomycin was as efficacious as comparator regimens among the ITT population (RRaEuroS=aEuroS0.98, 95% CI 0.93-1.03) but had a lower efficacy among the clinically evaluable (CE) population (RRaEuroS=aEuroS0.96, 95% CI 0.93-1.00). Subgroup analyses according to the quality of the trial, the type of antibiotic and the type of infection did not alter the outcomes. No significant difference was identified for all-cause mortality between the daptomycin and comparator groups (RRaEuroS=aEuroS1.17, 95% CI 0.76-1.79) but daptomycin therapy did reduce the duration of treatment. Daptomycin caused a significantly lower incidence of renal impairment, nausea and headache but caused a reversible increase in creatine phosphokinase (CPK). Subgroup analysis indicated that daptomycin was significantly associated with a higher incidence of CPK elevation and fewer renal impairments among the population with a mean age a parts per thousand currency sign60 years and a dose of daptomycin a parts per thousand yen6 mg/kg/24 h.

Daptomycin showed efficacy similar to the comparator regimens among the ITT population but lower efficacy among the CE population. Fewer adverse effects in total, but more CPK elevation effects, were observed in patients treated with daptomycin.

语种: 英语
所属项目编号: 81371856
项目资助者: National Natural Science Foundation of China
WOS记录号: WOS:000345767300002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62576
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: Peking Univ, Peoples Hosp, Dept Clin Lab, Beijing 100044, Peoples R China

Recommended Citation:
He, Wenqiang,Zhang, Yawei,Chen, Hongbin,et al. Efficacy and safety of daptomycin for the treatment of infectious disease: a meta-analysis based on randomized controlled trials[J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY,2014,69(12):3181-3189.
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