Systematic review of the treatment of upper respiratory tract infection
Systematic review of the treatment of upper respiratory tract infection
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DOI：
10.1136/adc.79.3.225
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发表时间：
1998-09-01
影响因子：
5.2
通讯作者：
Thomas, T
中科院分区：
文献类型：
--
作者：
Fahey, T;Stocks, N;Thomas, T
目的-评估抗生素治疗儿童上呼吸道感染（URTI）的风险和益处。设计-比较抗生素治疗与安慰剂的随机试验的定量系统评价。数据来源-从系统检索中检索到的12个试验（电子数据库、与作者的联系、与药品制造商的联系、参考文献列表）;主要结果测量-临床结果恶化或无变化的儿童比例;出现并发症或疾病进展的儿童比例;有副作用的儿童的比例。结果-1699名儿童被随机分配在六个试验，有助于荟萃分析。6项试验因结局不同或数据不完整而未用于荟萃分析。抗生素治疗并未改善临床结局（相对风险1.01，95%置信区间（CI）0.90至1.13），儿童并发症或疾病进展的比例也未改善（相对风险0.71，95% CI 0.45至1.12）。在报告该结局的5项试验中，URTI的并发症较低（范围2-15%）。与安慰剂相比，抗生素治疗与副作用增加无关（相对危险度0.8，95%CI 0.54 - 1.21）。结论：鉴于缺乏疗效和低并发症发生率，目前随机试验的证据不支持抗生素治疗URTI儿童。
Objectives-To assess the risks and benefits of antibiotic treatment in children with symptoms of upper respiratory tract infection (URTI).Design-Quantitative systematic review of randomised trials that compare antibiotic treatment with placebo.Data sources-Twelve trials retrieved from a systematic search (electronic databases, contact with authors, contact with drug manufacturers, reference lists); no restriction on language.Main outcome measures-The proportion of children in whom the clinical outcome was worse or unchanged; the proportion of children who suffered complications or progression of illness; the proportion of children who had side effects.Results-1699 children were randomised in six trials that contributed to the meta-analysis. Six trials were not used in the meta-analysis because of different outcomes or incomplete data. Clinical outcome was not improved by antibiotic treatment (relative risk 1.01, 95% confidence interval (CI) 0.90 to 1.13), neither was the proportion of children suffering from complications or progression of illness (relative risk 0.71, 95% CI 0.45 to 1.12). Complications from URTI in the five trials that reported this outcome was low (range 2-15%). Antibiotic treatment was not associated with an increase in side effects compared with placebo (relative risk 0.8, 95% CI 0.54 to 1.21).Conclusions-In view of the lack of efficacy and low complication rates, antibiotic treatment of children with URTI is not supported by current evidence from randomised trials.