Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis

LUO Menglin; XU Rufu; HU Xuelian; ZHANG Rong

doi:10.6039/j.issn.1001-0408.2023.09.17

您当前的位置：

首页 >

文章列表页 >

Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis

更新时间：2023-11-06

- Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis
- ZHONGGUO YAOFANG Vol. 34, Issue 9, Pages: 1115-1118(2023)
- 作者机构：
  
  陆军军医大学第二附属医院药学部，重庆　400037
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2023.09.17
  CLC： R978.5
- Published：15 May 2023，
  
  Received：19 January 2023，
  
  Revised：10 February 2023，
扫描看全文
罗梦林,许汝福,胡雪莲等.持续泵入对比间断滴注两性霉素B治疗侵袭性真菌感染疗效与安全性的Meta分析 ^Δ[J].中国药房,2023,34(09):1115-1118.

LUO Menglin,XU Rufu,HU Xuelian,et al.Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(09):1115-1118.
罗梦林,许汝福,胡雪莲等.持续泵入对比间断滴注两性霉素B治疗侵袭性真菌感染疗效与安全性的Meta分析 ^Δ[J].中国药房,2023,34(09):1115-1118. DOI： 10.6039/j.issn.1001-0408.2023.09.17.

LUO Menglin,XU Rufu,HU Xuelian,et al.Efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection： a meta-analysis[J].ZHONGGUO YAOFANG,2023,34(09):1115-1118. DOI： 10.6039/j.issn.1001-0408.2023.09.17.

摘要

目的

比较持续泵入与间断滴注两性霉素B治疗侵袭性真菌感染的疗效与安全性，为临床治疗提供循证参考。

方法

计算机检索PubMed、the Cochrane Library、Web of Science、Embase、万方、中国知网、中国生物医学文献数据库、维普网，收集24 h持续泵入（试验组）对比间断滴注（对照组）两性霉素B的随机对照试验（RCT）及队列研究，检索时间均从建库起至2023年1月。筛选文献、提取资料后采用改良的Jadad量表评价RCT的质量，采用纽卡斯尔-渥太华评分量表评价队列研究的质量；采用RevMan 5.4软件进行Meta分析、敏感性分析。

结果

共纳入7篇文献，包括1篇RCT及6篇队列研究，共计767例患者。Meta分析结果显示，试验组患者的临床有效率[RR＝1.44，95%CI（1.13，1.83），

＝0.003]显著高于对照组，全因死亡率[RR＝0.37，95%CI（0.19，0.72），

＝0.003]、输液反应发生率[RR＝0.28，95%CI（0.18，0.43），

＜0.000 01]均显著低于对照组；两组患者的肾功能损害发生率比较，差异无统计学意义[RR＝0.71，95%CI（0.45，1.11），

＝0.13]。敏感性分析结果显示，本研究所得结果稳健。

结论

24 h持续泵入两性霉素B治疗侵袭性真菌感染的疗效和安全性均优于间断滴注。

Abstract

OBJECTIVE

To compare efficacy and safety of continuous pump versus intermittent infusion of amphotericin B in the treatment of invasive fungal infection， and to provide evidence-based reference for clinical treatment.

METHODS

Retrieved from PubMed， the Cochrane Library， Web of Science， Embase， Wanfang， CNKI， CBM and VIP database， randomized controlled trial （RCT） and cohort study about 24 h continuous pump （trial group） versus intermittent infusion （control group） of amphotericin B were collected from the inception to Jan. 2023. After literature screening and data extraction， the quality of RCT was evaluated with modified Jadad scale， and the quality of cohort study was evaluated with Newcastle-Ottawa scale. Meta-analysis and sensitivity analysis were performed by using RevMan 5.4 software.

RESULTS

A total of 7 literature were included， involving 1 RCT and 6 cohort studies with a total of 767 patients. The results of meta-analysis showed that the clinical effective rate [RR＝1.44， 95%CI（1.13，1.83），

＝0.003] of trial group was significantly higher than that of control group， and all-cause mortality rate [RR＝0.37，95%CI（0.19，0.72），

＝0.003] and the incidence rate of infusion reaction [RR＝0.28，95%CI（0.18，0.43），

＜0.000 01] were significantly lower than control group； there was no statistical significance in the incidence rate of renal impairment between 2 groups [RR＝0.71，95%CI（0.45，1.11），

＝0.13] . The sensitivity analysis results showed that the results obtained in this study were robust.

CONCLUSIONS

The efficacy and safety of 24 h continuous pump of amphotericin B are better than those of intermittent infusion in the treatment of invasive fungal infection.

关键词

侵袭性真菌感染两性霉素B持续泵入间断滴注疗效安全性Meta分析

Keywords

amphotericin Bcontinuous pumpintermittent infusionefficacysafetymeta-analysis

references

LEHRNBECHER T，PHILLIPS R，ALEXANDER S，et al. Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation[J]. J Clin Oncol，2012，30（35）：4427-4438.

BRANCH R A. Prevention of amphotericin B-induced renal impairment. A review on the use of sodium supplementation[J]. Arch Intern Med，1988，148（11）：2389-2394.

PATTERSON T F，3rdTHOMPSON G R，DENNING D W，et al. Practice guidelines for the diagnosis and management of aspergillosis：2016 update by the Infectious Diseases Society of America[J]. Clin Infect Dis，2016，63（4）：e1-e60.

PAPPAS P G，KAUFFMAN C A，ANDES D R，et al. Executive summary：clinical practice guideline for the management of candidiasis：2016 update by the Infectious Diseases Society of America[J]. Clin Infect Dis，2016，62（4）：409-417.

LEWIS R E，WIEDERHOLD N P. The solubility ceiling：a rationale for continuous infusion amphotericin B therapy?[J]. Clin Infect Dis，2003，37（6）：871-872.

GREEN S，HIGGINS J P. Preparing a cochrane review[M]//Cochrane Handbook for Systematic Reviews of Interventions. Chichester，UK：John Wiley & Sons，Ltd，2008：11-30.

STANG A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses[J]. Eur J Epidemiol，2010，25（9）：603-605.

ERIKSSON U，SEIFERT B，SCHAFFNER A. Comparison of effects of amphotericin B deoxycholate infused over 4 or 24 hours：randomised controlled trial[J]. BMJ，2001，322（7286）：579-582.

LEE Y K，KIM Y H，JEONG O H M D. Comparison of effects and side effects of amphotericin B deoxycholate infusion over 6 versus 24 hours in children with cancer[J].Korean J Pediatr Hematol Oncol，2003，10（2）：223-229.

PELEG A Y，WOODS M L. Continuous and 4 h infusion of amphotericin B：a comparative study involving high-risk haematology patients[J]. J Antimicrob Chemother，2004，54（4）：803-808.

SCHULENBURG A，SPERR W，RABITSCH W，et al. Brief report：practicability and safety of amphotericin B deoxycholate as continuous infusion in neutropenic patients with hematological malignancies[J]. Leuk Lymphoma，2005，46（8）：1163-1167.

MAHAROM P，THAMLIKITKUL V. Implementation of clinical practice policy on the continuous intravenous administration of amphotericin B deoxycholate[J]. Chotmaihet Thangphaet，2006，89（Suppl 5）：S118-S124.

ALTMANNSBERGER P，HOLLER E，ANDREESEN R，et al. Amphotericin B deoxycholate：no significant advantage of a 24 h over a 6 h infusion schedule[J]. J Antimicrob Chemother，2007，60（1）：180-182.

GEERSING T H，FRANSSEN E J F，SPRONK P E，et al. Nephrotoxicity of continuous amphotericin B in critically ill patients with abdominal sepsis：a retrospective analysis with propensity score matching[J]. J Antimicrob Chemother，2021，77（1）：246-252.

FALAGAS M E，TANSARLI G S，IKAWA K，et al. Clinical outcomes with extended or continuous versus short-term intravenous infusion of carbapenems and piperacillin/tazobactam：a systematic review and meta-analysis[J]. Clin Infect Dis，2013，56（2）：272-282.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Meta-analysis of efficacy and safety of aspirin versus other anticoagulants in the prevention of thromboembolism after orthopedic surgery

Meta-analysis of the efficacy and safety of Saccharomyces boulardii versus Bifidobacterium triple live bacteria in the treatment of pediatric diarrhea

Meta-analysis of efficacy and safety of cabozantinib in the treatment of advanced thyroid cancer

Meta-analysis of efficacy and safety of belimumab in the treatment of childhood-onset systemic lupus erythematosus

Efficacy and safety of new oral anticoagulants in patients with nonvalvular atrial fibrillation after left atrial appendage occlusion：a meta-analysis

Related Author

WANG Pei

WEI Meng

TAO Yingying

ZHAO Yulei

WANG Jing

ZHOU Qiang

ZHANG Xiaodan

WANG Ruiqin

Related Institution

Dept. of Pharmacy， General Hospital of Eastern Theater Command

Dept. of Clinical Pharmacy， General Hospital of Eastern Theater Command

Dept. of Cardiology， General Hospital of Eastern Theater Command

School of Medicine and Pharmacy， Ocean University of China

Dept. of Pharmacy， Qingdao Women and Children’s Hospital

Address：8/F,129 Daping Main Street,Yuzhong District,Chongqing 400042,P.R.China
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰