急性胆管炎的短期抗生素治疗并不亚于长期抗生素治疗:一个系统性回顾。

时间:2018-12-24 作者:王君俊 审校:张立超 点击:1026次

急性胆管炎的短期抗生素治疗并不亚于长期抗生素治疗:一个系统性回顾。

目的:我们的目的是总结急性胆管炎的短期和长期抗生素治疗疗效的文献。
方法:这篇系统性回顾是基于PRISMA声明。我们在三个数据库中搜索关于讨论急性胆管炎使用抗生素疗程的文献。治疗的长期和短期是基于文章发表时可用的最新指南定义的。首要结果为胆管炎复发率和死亡率;次要结果包括住院时长和ERCP术后发热持续时间。数据是基于这些结果和一般特征上提取的。然后根据收集的数据叙述综合。
结果:在我们搜寻的692篇文章中,有4篇符合纳入和排除标准。这些包含205名急性胆管炎患者,137名和68名患者分别接受短期和长期抗生素治疗。两组间患者死亡率和ERCP术后发热持续时间的研究无显著性差异。4篇研究中有1篇发现短期抗生素治疗胆管炎的复发率显著降低(0%比13.3%,P=0.036)。在相同的回顾性文章中仅比较住院时长时,发现短期抗生素治疗的住院时间明显缩短(中位数为14比17.5天,P<0.001)。
结论:我们的回顾表明短期抗生素治疗不亚于长期抗生素治疗;然而,一些限制强调了充分设计随机试验的需要。
 
 
Short-Course Antibiotic Treatment Is Not Inferior to a Long-Course One in Acute Cholangitis: A Systematic Review

Benedek Tinusz, László Szapáry, Bence Paládi, et al. Digestive Diseases and Sciences
 
AIMS:Our aim was to summarize the available literature on the effect of short- versus long-course antibiotic therapy on acute cholangitis.
METHODS:A systematic review was performed according to the PRISMA Statement. We searched three databases for papers discussing the length of ABT in acute cholangitis. Long and short therapy groups were defined based on the most recent guideline available at the time of publication of the articles. Primary outcomes were the rate of recurrent cholangitis and mortality; secondary outcomes included length of hospitalization and the duration of fever after ERCP. Data were extracted on these outcomes and on general characteristics. A narrative synthesis was then provided based on collected data.
 
RESULTS:Out of 692 articles produced by our search, four met our inclusion and exclusion criteria. These contained 205 acute cholangitis patients, with 137 and 68 patients receiving short and long antibiotic therapy, respectively. No significant difference was observed in any of the studies on the outcomes of mortality and duration of fever after ERCP between the two groups. One out of four studies found the rate of recurrent cholangitis to be significantly lower in the short antibiotic therapy group (0.0% vs. 13.3%, p = 0.036). Length of hospitalization was only compared in the same retrospective article, where it was found to be significantly shorter in the short-term antibiotic therapy group (with a median of 14 vs. 17.5 days, p < 0.001).
 
CONCLUSIONS:Our review suggests short-course antibiotic therapy is non-inferior to long-course treatment; however, several limitations underline the need for well-designed randomized trials.
 
翻译:王君俊 审校:张立超、侯森林