Quantitative systematic review of randomised controlled trials comparing antibiotic with placebo for acute cough in adults
Quantitative systematic review of randomised controlled trials comparing antibiotic with placebo for acute cough in adults
复制标题
DOI：
10.1136/bmj.316.7135.906
复制
发表时间：
1998-03-21
影响因子：
--
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：评估抗生素治疗急性咳嗽是否有效，并测量这种治疗的副作用。设计：随机安慰剂对照试验的定量系统评价。数据来源：从系统检索（电子数据库、与作者联系、与药品制造商联系、参考文献清单）中检索9项试验（8项已发表，1项未发表）；没有语言限制。主要观察指标：随访时（全科医生会诊后7-11天）出现生产性咳嗽的受试者比例；随访时临床症状未改善的受试者比例；报告服用抗生素或安慰剂产生副作用的受试者比例。结果：8项试验参与了meta分析。抗生素治疗对咳嗽的缓解没有影响（相对危险度0.85(95%可信区间0.73 ~ 1.00)），复查时的临床改善也没有影响（相对危险度0.62(0.36 ~ 1.09)）。与安慰剂相比，抗生素组抗生素的副作用更常见（相对风险1.51(0.86 - 2.64)）。结论：抗生素治疗不影响咳嗽的消退或改变病程。对大多数急性咳嗽患者来说，抗生素治疗的益处是微乎其微的，而且可能被治疗的副作用所抵消。
Objectives: To assess whether antibiotic treatment for acute cough is effective and to measure the side effects of such treatmentDesign: Quantitative systematic review of randomised placebo controlled trials.Data sources: Nine trials (8 published, 1 unpublished) retrieved from a systematic search (electronic databases, contact with authors, contact with drug manufacturers, reference lists); no restriction on language.Main outcome measures: Proportion of subjects with productive cough at follow up (7-11 days after consultation with general practitioner); proportion of subjects who had not improved clinically at follow up; proportion of subjects who reported side effects from taking antibiotic or placebo.Results: Eight trials contributed to the meta-analysis. Resolution of cough was not affected by antibiotic treatment (relative risk 0.85 (95% confidence interval 0.73 to 1.00)), neither was clinical improvement at re-examination (relative risk 0.62 (0.36 to 1.09)). The side effects of antibiotic were more common in the antibiotic group when compared to placebo (relative risk 1.51 (0.86 to 2.64)).Conclusions: Treatment with antibiotic does not affect the resolution of cough or alter the course of illness. The benefits of antibiotic treatment are marginal for most patients with acute cough and may be outweighed by the side effects of treatment.