比较万古霉素持续输注与间断输注引起肾毒性的荟萃分析

郑丽丽; 轩辕欢; 姜倩; 范芳芳; 姚莉; 赵生俊

doi:10.3969/j.issn.1006-0111.2018.02.009

比较万古霉素持续输注与间断输注引起肾毒性的荟萃分析

doi: 10.3969/j.issn.1006-0111.2018.02.009

新疆医科大学附属中医医院药学部, 新疆乌鲁木齐 830054

基金项目: 国家自然科学基金（81460603）

Meta-analysis on renal toxicity of vancomycin given by continuous infusion vs intermittent infusion

Department of Pharmacy, Traditional Chinese Medical Hospital Affiliated to Xinjiang Medical University, Urumqi 830054, China

摘要: 目的比较万古霉素两种给药方式（持续输注与间断输注）引起的肾毒性。方法计算机检索Embase、PubMed、The Cochrane Register of Controlled Trials和CBM、CNKI、万方数据库。采用Cochrane协作网提供的Revman5.2软件进行Meta分析。结果共纳入2篇随机对照试验（RCT）和8篇观察性研究，共纳入患者1 764例，其中持续输注1 037例，间断输注727例。持续输注与间断输注引起的肾毒性发生率无显著性差异（P>0.05）。结论万古霉素持续输注较间断输注不能有效降低肾毒性的发生率。
- 万古霉素 /
- 持续输注 /
- 间断输注 /
- 肾毒性 /
- 荟萃分析
Abstract: Objective To compare the renal toxicity of vancomycin with continuous infusion vs intermittent infusion. Methods The databases of EMBASE, PUBMED, the Cochrane Register of Controlled Trials, CBM, CNKI and WanFang were searched. The Cochrane Revman5.2 software was used for Meta-analysis. Results Two RCTs and eight observational studies were included in the systematic literature search with total of 1 764 patients. 1 037 patients received vancomycin with continuous infusion while 727 patients with intermittent infusion. The Meta-analysis indicated that there was no significant difference in renal toxicity between continuous infusion group and intermittent infusion group(P>0.05). Conclusion Vancomycin continuous infusion cannot effectively reduce the incidence of renal toxicity.
- vancomycin /
- continuous infusion /
- intermittent infusion /
- renal toxicity /
- Meta-analysis

[1]	万古霉素临床应用剂量专家组.万古霉素临床应用剂量中国专家共识[J].中华传染病杂志,2012,30(11):641-646.
[2]	Liu C,Bayer A,Cosgrove S E,et al.Clinical practice guidelines by the infectious diseases society of America for the treatment of Methicillin-Resistant Staphylococcus aureus infections in adults and children:executive summary[J].Clin Infect Dis,2011,52(3):285-292.
[3]	耐甲氧西林金黄色葡萄球菌感染防治专家委员会.耐甲氧西林金黄色葡萄球菌感染防治专家共识[J].中华实验和临床感染病杂志(电子版),2010,4(2):215-223.
[4]	陈春辉,李光辉.美国感染病学会治疗成人及儿童甲氧西林耐药金黄色葡萄球菌感染临床实践指南[J].中国感染与化疗杂志,2011,11(6):428-435.
[5]	Rybak M, Lomaestro B, Rotschafer JC, et al.Therapeutic monitoring of vancomycin in adult patients:a consensus review of the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, and the Society of Infectious Diseases Pharmacists[J]. Am J Health Syst Pharm,2008,66(1):82-98.
[6]	van Hal SJ, Paterson DL, Lodise TP. Systematic review and meta-analysis of vancomycin-induced nephrotoxicity associated with dosing schedules that maintain troughs between 15 and 20 milligrams per liter[J]. Antimicrob Agents Chemother, 2013,57(2):734-744.
[7]	黄榜江,肖政,汪成琼,等.我国慢性阻塞性肺病院内真菌感染特征及高危药物因素的Meta分析[J].实用医学杂志,2015,31(1):110-115.
[8]	Higgins Jpt GS. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[J]. Cochrane Database of Systematic Reviews,2011,2011(2):S38.
[9]	吴泰相,商洪才,卞兆祥.随机对照实况试验的概念,设计和实施[J].中国循证医学杂志,2009,9(12):1277-1280.
[10]	陈耀龙,李晓,梅又文,等.循证医学术语介绍V[J].中国循证医学杂志,2009,9(7):734-739.
[11]	Wysocki M, Thomas F, Wolff MA, et al. Comparison of continuous with discontinuous intravenous infusion of vancomycin in severe MRSA infections[J]. J Antimicrob Chemother, 1995,35(2):352-354.
[12]	Wysocki M, Delatour F, Faurisson F, et al. Continuous versus intermittent infusion of vancomycin in severe staphylococcal infections:prospective multicenter randomized study[J]. Antimicrob Agents Chemother, 2001,45(9):2460-2467.
[13]	Vuagnat A, Stern R, Lotthe A, et al. High dose vancomycin for osteomyelitis:continuous vs. intermittent infusion[J]. J Clin Pharm Ther,2004,29(4):351-357.
[14]	Hutschala D, Kinstner C, Skhirdladze K, et al. Influence of vancomycin on renal function in critically ill patients after cardiac surgery:continuous versus intermittent infusion[J]. Anesthesiology,2009,111(2):356-365.
[15]	Ingram PR, Lye DC, Fisher DA, et al. Nephrotoxicity of continuous versus intermittent infusion of vancomycin in outpatient parenteral antimicrobial therapy[J]. Int J Antimicrob Agents, 2009,34(6):570-574.
[16]	Schmelzer TM, Christmas AB, Norton HJ, et al. Vancomycin intermittent dosing versus continuous infusion for treatment of ventilator-associated pneumonia in trauma patients[J]. Am Surg, 2013,79(11):1185-1190.
[17]	Hanrahan TP, Harlow G, Hutchinson J, et al. vancomycin-associated nephrotoxicity in the critically ill:a retrospective multivariate regression analysis[J]. Crit Care Med, 2014,42(12):2527-2536.
[18]	Di Filippo A,De Gaudio AR,Novelli A,et al.Continuous infusion of vancomycin in methicillin-resistant staphylococcus infection[J].Chemotherapy,1998,44(1):63-68.
[19]	Akers KS,Cota JM,Chung KK,et al.Serum vancomycin levels resulting from continuous or intermittent infusion in critically ill burn patients with or without continuous renal replacement therapy[J].J Burn Care Res,2012,33(6):e254-e262.
[20]	Saugel B,Nowack MC, Hapfelmeier A,et al.Continuous intravenous administration of vancomycin in medical intensive care unit patients[J].J Crit Care,2013,28(1):9-13.
[21]	薛敬一,徐晓涵,陈恳,等.万古霉素持续输注与间断输注的系统评价与Meta分析[J].中国临床药理学杂志,2015,31(13):1348-1352.

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比较万古霉素持续输注与间断输注引起肾毒性的荟萃分析

doi: 10.3969/j.issn.1006-0111.2018.02.009

Meta-analysis on renal toxicity of vancomycin given by continuous infusion vs intermittent infusion

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比较万古霉素持续输注与间断输注引起肾毒性的荟萃分析

doi: 10.3969/j.issn.1006-0111.2018.02.009

新疆医科大学附属中医医院药学部, 新疆乌鲁木齐 830054

English Abstract

Meta-analysis on renal toxicity of vancomycin given by continuous infusion vs intermittent infusion

Department of Pharmacy, Traditional Chinese Medical Hospital Affiliated to Xinjiang Medical University, Urumqi 830054, China

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比较万古霉素持续输注与间断输注引起肾毒性的荟萃分析

doi: 10.3969/j.issn.1006-0111.2018.02.009

Meta-analysis on renal toxicity of vancomycin given by continuous infusion vs intermittent infusion

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比较万古霉素持续输注与间断输注引起肾毒性的荟萃分析

doi: 10.3969/j.issn.1006-0111.2018.02.009

新疆医科大学附属中医医院药学部, 新疆 乌鲁木齐 830054

English Abstract

Meta-analysis on renal toxicity of vancomycin given by continuous infusion vs intermittent infusion

Department of Pharmacy, Traditional Chinese Medical Hospital Affiliated to Xinjiang Medical University, Urumqi 830054, China

全文HTML

目录

新疆医科大学附属中医医院药学部, 新疆乌鲁木齐 830054