Nephrotoxicity prevalence in patients treated with polymyxins: a systematic review with meta-analysis of observational studies
Nephrotoxicity prevalence in patients treated with polymyxins: a systematic review with meta-analysis of observational studies
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DOI：
10.1016/j.diagmicrobio.2018.11.008
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发表时间：
2019-05-01
影响因子：
2.9
通讯作者：
Sanches, Andreia C.
中科院分区：
文献类型：
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作者：
Oliota, Ana F.;Penteado, Suelem T.;Sanches, Andreia C.
由于缺乏有效的抗生素来治疗革兰氏阴性菌引起的新发感染，粘菌素和多粘菌素B越来越多地重新引入临床实践。综合目前关于多粘菌素特性的证据，特别是关于肾毒性的证据，是必要的。本研究旨在对队列型观察性研究进行系统回顾和荟萃分析，以确定接受粘菌素或多粘菌素b治疗的患者肾毒性的发生率。检索PubMed、Scopus和DOAJ电子数据库，并进行人工检索。包括评估成人患者由粘菌素或多粘菌素B引起的肾损害（肾毒性）的队列研究。进行了肾毒性患病率的荟萃分析以及累积荟萃分析和荟萃回归。系统检索后，纳入95个队列（n = 7911例患者）进行分析。粘菌素的肾毒性患病率为26.7%[置信区间（CI） 95%: 22.8-30.9%]，多粘菌素B的肾毒性患病率为29.8% (CI 23.8-36.7%) （P = 0.720）。研究的发表年份、用于分类肾损害的标准以及肾毒性作为主要或次要结局对不良事件发生率有显著影响。(C) 2018爱思唯尔公司版权所有。
Colistin and polymyxin B are increasingly reintroduced in clinical practice due to the absence of effective antibiotics for the treatment of emerging infections caused by gram-negative bacteria. The synthesis of current evidence on the characteristics of polymyxins, especially regarding nephrotoxicity, is necessary. This study aims to conduct a systematic review and meta-analysis of cohort-type observational studies in order to identify the prevalence of nephrotoxicity in patients treated with either colistin or polymyxin B. PubMed, Scopus, and DOAJ electronic databases were searched, and manual searches were done. Cohort studies evaluating renal damage (nephrotoxicity) in adult patients caused by colistin or polymyxin B were included. Meta-analyses of the prevalence of nephrotoxicity as well as cumulative meta-analysis and meta-regression were conducted. After the systematic searches, 95 cohorts (n = 7911 patients) were included for analysis. The nephrotoxicity prevalence was 26.7% [confidence interval (CI) 95%: 22.8-30.9%] for colistin and 29.8% (CI 23.8-36.7%) for polymyxin B (P = 0.720). The publication year of the studies, the criteria used to classify renal damage, and the nephrotoxicity as primary or secondary outcome showed a significant influence on the adverse event rates. (C) 2018 Elsevier Inc. All rights reserved.