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Efficacy and safety of daptomycin for the treatment of infectious disease: a meta-analysis based on randomized controlled trials
He, Wenqiang; Zhang, Yawei; Chen, Hongbin; Zhao, Chunjiang; Wang, Hui
关键词CPK elevation renal impairment lipopeptides
刊名JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
2014-12-01
DOI10.1093/jac/dku277
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
WOS记录号WOS:000345767300002
项目编号81371856
资助机构National Natural Science Foundation of China
引用统计
被引频次:13[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/62576
专题北京大学第二临床医学院
作者单位Peking Univ, Peoples Hosp, Dept Clin Lab, Beijing 100044, Peoples R China
推荐引用方式
GB/T 7714
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.
APA He, Wenqiang,Zhang, Yawei,Chen, Hongbin,Zhao, Chunjiang,&Wang, Hui.(2014).Efficacy and safety of daptomycin for the treatment of infectious disease: a meta-analysis based on randomized controlled trials.JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY,69(12),3181-3189.
MLA He, Wenqiang,et al."Efficacy and safety of daptomycin for the treatment of infectious disease: a meta-analysis based on randomized controlled trials".JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 69.12(2014):3181-3189.
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