Fluoroquinolone prophylaxis in patients with neutropenia: a meta-analysis of randomized placebo-controlled trials
Fluoroquinolone prophylaxis in patients with neutropenia: a meta-analysis of randomized placebo-controlled trials
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DOI：
10.1007/s10096-007-0397-y
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发表时间：
2008-01-01
影响因子：
4.5
通讯作者：
Montori, V. M.
中科院分区：
文献类型：
--
作者：
Imran, H.;Tleyjeh, I. M.;Montori, V. M.
最近的一项荟萃分析（包括非安慰剂开放标记试验）表明，氟喹诺酮预防可以降低中性粒细胞减少症患者的死亡率，而最近的两项大型试验未能显示出类似的益处。因此，我们对中性粒细胞减少症患者氟喹诺酮预防的随机、盲法、安慰剂对照试验进行了荟萃分析。我们在多个数据库中搜索了任何语言的相关试验。我们使用随机效应模型来汇集二分数据，并使用 I-2 评估研究间的不一致性。两名研究者独立评估了纳入试验的资格和质量。八项符合条件的试验共有 2,721 名患者被随机分配。与安慰剂相比，氟喹诺酮预防的死亡率在统计学上不显着但一致下降（4.5% vs. 3.9%，相对风险 (RR) 0.76，95% 置信区间 (CI) 0.54、1.08，p = 0.13，I-2 = 0%）。然而，发热发作的汇总分析却存在显着的不一致（39% vs. 31%，RR 0.76，95% CI 0.55、1.03，p = 0.08，I-2 = 96.5%）。在某种程度上，这种不一致在亚组分析中可以通过所研究的患者群体类型和所使用的氟喹诺酮类型来解释（p表示相互作用）
A recent meta-analysis, which included non-placebo open-labeled trials, showed that fluoroquinolone prophylaxis reduces mortality in neutropenic patients, whereas two recent large trials failed to show a similar benefit. Therefore, we performed a meta-analysis of randomized, blinded, placebo-controlled trials of fluoroquinolone prophylaxis in neutropenic patients. We searched several databases for relevant trials in any language. We used random effects models for pooling dichotomous data and assessed the between-study inconsistency with I-2. Two investigators independently assessed the eligibility and quality of the included trials. A total of 2,721 patients were randomized in eight eligible trials. Compared to the placebo, there was a statistically non-significant but consistent decrease in mortality with fluoroquinolone prophylaxis (4.5% vs. 3.9%, relative risk (RR) 0.76, 95% confidence interval (CI) 0.54, 1.08, p = 0.13, I-2 = 0%). Significant inconsistency, however, accompanied the pooled analysis of febrile episode (39% vs. 31%, RR 0.76, 95% CI 0.55, 1.03, p = 0.08, I-2 = 96.5%). To an extent, this inconsistency was explained in the subgroup analyses by the type of patient population studied and the type of fluoroquinolone used (p for interaction