Reported rates of diarrhea following oral penicillin therapy in pediatric clinical trials.
Reported rates of diarrhea following oral penicillin therapy in pediatric clinical trials.
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DOI：
10.5863/1551-6776-20.2.90
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发表时间：
2015-03-01
期刊：
影响因子：
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通讯作者：
Sharland, Mike
中科院分区：
文献类型：
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作者：
Kuehn, Jemima;Ismael, Zareen;Sharland, Mike
抗生素相关性腹泻（AAD）是公认的口服青霉素的不良反应。本综述分析了文献，以确定AAD的发病率阿莫西林，阿莫西林/克拉维酸，青霉素V口服治疗在儿科clinical trials.METHODS：先进的搜索进行了MEDLINE和Embase数据库的文章在任何语言报告AAD的发病率口服青霉素治疗后的任何指示感染的儿童（0-17岁）。检索仅限于临床试验。文章被排除，如果治疗是与慢性疾病，涉及伴随抗菌药物，或者如果剂量或患者人数未指定。结果：四百三十五篇文章有关的临床试验（307从Embase; 128从MEDLINE）。纳入了报告42项研究的35篇文章进行分析。适应症包括急性中耳炎、鼻窦炎、咽炎和肺炎。33项试验报告了阿莫西林/克拉维酸，6项报告了阿莫西林，3项报告了青霉素V。总共42项试验包括7729名接受口服青霉素治疗的儿童。平均而言，17.2%患有AAD。合并每种青霉素的数据。阿莫西林/克拉维酸的AAD发生率为19.8%，阿莫西林为8.1%，青霉素V为1.2%。根据制剂：合并平均值分析阿莫西林/克拉维酸数据。ADD的发病率为24.6%的4：1配方，12.8%的7：1配方，19.0%的8：1配方，和20.2%的14：1 formulation.CONCLUSIONS：这些结果表明大大增加AAD的发病率使用阿莫西林/克拉维酸，使用阿莫西林和青霉素V相比，以及不同的AAD率与不同的阿莫西林/克拉维酸配方。这些发现值得在处方时考虑。儿童AAD的潜在机制尚不清楚。
OBJECTIVES: Antibiotic-associated diarrhea (AAD) is a well-recognized adverse reaction to oral penicillins. This review analyzed the literature to determine the incidence of AAD following amoxicillin, amoxicillin/clavulanate, and penicillin V oral therapy in pediatric clinical trials.METHODS: An advanced search was conducted in MEDLINE and Embase databases for articles in any language reporting the incidence of AAD following oral penicillin therapy for any indicated infection in children (0-17 years). The search was limited to clinical trials. Articles were excluded if treatment was related to chronic conditions, involved concomitant antimicrobials, or if the dose or number of patients was not specified.RESULTS: Four hundred thirty-five articles relating to clinical trials were identified (307 from Embase; 128 from MEDLINE). Thirty-five articles reporting on 42 studies were included for analysis. The indications included acute otitis media, sinusitis, pharyngitis, and pneumonia. Thirty-three trials reported on amoxicillin/clavulanate, 6 on amoxicillin, and 3 on penicillin V. In total, the 42 trials included 7729 children who were treated with an oral penicillin. On average, 17.2% had AAD. Data were pooled for each penicillin. The AAD incidence was 19.8% for amoxicillin/clavulanate, 8.1% for amoxicillin, and 1.2% for penicillin V. The amoxicillin/clavulanate data were analyzed according to formulation: pooled-average. The incidence of ADD was 24.6% for the 4:1 formulation, 12.8% for the 7:1 formulation, 19.0% for the 8:1 formulation, and 20.2% for the 14:1 formulation.CONCLUSIONS: These results demonstrate substantially increased incidence of AAD following use of amoxicillin/clavulanate, compared to use of amoxicillin and penicillin V, as well as varying AAD rates with diffierent amoxicillin/clavulanate formulations. These findings warrant consideration when prescribing. The underlying mechanisms of AAD in children remain unclear.