Meta-analysis of the efficacy and safety of piperacillin-tazobactam plus fluoroquinolones in the treatment of non-critical patients with lower respiratory tract infections
AIM To systematically review the validity and safety of piperacillin-tazobactam plus fluoroquinolones in the therapy of non-critical patients with lower respiratory tract infections.METHODS The foreign databases including the Cochrane Library,PubMed,Embase,Web of Science,and Chinese databases including CNKI,WanFang,VIP,and CBM were searched to collect randomized controlled trials(RCTs)involving the comparison of piperacillin-tazobactam monotherapy with piperacillin-tazobactam plus fluoroquinolones for the treatment of non-critical patients with lower respiratory tract infections up to April 2023.The Meta-analysis and sensitivity analysis were conducted using the RevMan 5.4 and Stata 18.0 software respectively.RESULTS 14 RCTs involving 1116 patients were included.The Meta-analysis results indicated that the fluoroquinolones plus piperacillin-tazobactam could improve treatment efficacy[OR=4.77,95％CI(3.04-7.49),Z=6.79,P＜0.000 01],shorten cough relief time[OR=-2.08,95％CI(-3.43--0.72),Z=3.01,P=0.003],shorten body temperature recovery time[OR=-2.14,95％CI(-2.83--1.45),Z=6.05,P＜0.000 01],shorten lesions absorption time[OR=-2.28,95％CI(-3.50--1.06),Z=3.66,P=0.000 3],effectively lower C-reactive protein(CRP)level[OR=6.48,95％CI(0.59-12.36),Z=2.16,P=0.03],and improve bacterial clearance rate[OR=4.51,95％CI(2.00-10.16),Z=3.64,P=0.000 3]compared to piperacillin-tazobactam monotherapy.There was no significant difference in the decrease in levels of white blood cell and adverse drug reactions between 2 groups(P＞0.05).CONCLUSION Piperacillin-tazobactam plus fluoroquinolones could improve clinical efficacy,alleviate symptoms,and show good safety in the treatment of non-critical patients with lower respiratory tract infections.However,due to the difference in methodological quality,a small sample size,and more high-quality and large-sample RCTs evidence support is still needed.
国家科技期刊平台
NSTL
万方数据
