Efficacy and Safety of Four Kinds of Intravenous Preparations of Amphotericin B in the Treatment of Fungal Infections:A Network Meta-analysis
OBJECTIVE:To evaluate the efficacy and safety of four kinds of intravenous preparations of amphotericin B in the treatment of fungal infections based on network Meta-analysis.METHODS:PubMed,Scopus,Web of Science,the Cochrane Library,Embase,CNKI,Wanfang Data,VIP and CBM were retrieved to collect the randomized controlled trial(RCT)of amphotericin B with triazole or echinocandins in the treatment of fungal infections for network Meta-analysis.The retrieval time was from the establishment of the database to Aug.5th,2023.The quality of literature was evaluated according to GRADE.RESULTS:A total of 16 literature with 4 365 patients were included.In terms of efficacy,amphotericin B liposomes>amphotericin B deoxycholate>amphotericin B colloid dispersion,the difference was statistically significant(P<0.05),while amphotericin B liposomes complex had no statistical significance compared with other amphotericin B(P>0.05).There was no significant difference in the total incidence of adverse drug reactions among four kinds of intravenous preparations of amphotericin B(P>0.05).Subgroup analysis showed that amphotericin B deoxycholate had higher neurotoxicity than amphotericin B colloidal dispersion,with statistically significant differences(P<0.05).CONCLUSIONS:Among the four kinds of intravenous preparations of amphotericin B,efficacy of liposome dosage form is better than that of traditional dosage form of deoxycholate.The efficacy of colloid dispersion dosage form is significantly lower than that of traditional dosage form,with lower toxicity of nervous system.Due to the limited number of literature included in the study,there may be publication bias,more clinical literature with large sample size and high quality are needed to confirm the results and conclusions of this study.
万方数据
维普
