ABSTRACT
OBJECTIVE To eva luate the clinical comprehensive value of desloratadine in the treatment of urticaria. METHODS The clinical comprehensive evaluation index system based on six dimensions such as safety ，effectiveness，economy，suitability， innovation and accessibility were preliminarily determined by using the methods of literature investigation and expert investigation ； the core contents of the evaluation index system were evaluated and screened by Delphi method and analytic hierarchy process ；the importance of the index was assigned by Likert 5-level scoring method ；the evidence from various sources were collected and qualitative and quantitative integration analysis were conducted according to the clinical comprehensive evaluation index system with the help of system evaluation ，drug instructions ，expert guidelines/consensus ，adverse drug reaction monitoring report ，etc； the experts scored its clinical comprehensive value according to the clinical comprehensive evaluation evidence of each dimension of desloratadine ，combined with the weight of the clinical comprehensive evaluation index system ，the clinical comprehensive evaluation score of the tertiary indexes of desloratadine were calculated. The total clinical comprehensive evaluation score was obtained by accumulating the scores of each index ，and compared with loratadine. RESULTS This study successfully constructed the clinical comprehensive evaluation index system of desloratadine in the treatment of urticaria ，including 6 primary indexes ，13 secondary indexes and 30 tertiary indexes. The total clinical comprehensive evaluation score of desloratadine was 93.63 and that of loratadine was 70.91. CONCLUSIONS The clinical comprehensive value of desloratadine is higher than that of loratadine ，which can provide a reference basis for clinical rational drug use in medical institutions ，selection of drug use catalogue and improvement of national drug policy.
ABSTRACT
OBJECTIVE：To systematically evaluate the safety of meropenem for neonatal infection ，and to provide evidence-based reference for safe use of it in the neonatal population. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library，ISI Web of Science ，International Health Technology Assessment Network Website ，China Journal Full-text Database ， Wanfang Database ，CBM，Chinese Sci-tech Periodical Full-text Database ，randomized controlled trials （RCTs）about meropenem or meropenem combined other drugs （trial group ）versus the similar drugs that could replace meropenem （control group ）for neonatal infection were collected during the inception to May 1st，2021. After literature screening and data extraction ，the quality of included literatures were evaluated with Cochrane systematically evaluator manual 5.1.0. Meta-analysis was conducted with RevMan 5.3 software. RESULTS ：A total of 25 RCTs were included ，involving 2 090 children. Results of Meta-analysis showed that the incidence of overall ADR in trial group was significantly lower than control group [RR ＝0.53，95％CI（0.44，0.65），P＜0.000 01]. Results of subgroup analysis showed that the incidence of overall ADR in trial group was significantly lower than control group receiving ceftazidime [RR ＝0.55，95％CI（0.41，0.74），P＜0.000 1]，tigecycline [RR ＝0.37，95％CI（0.23，0.59），P＜0.000 1]， ceftriaxone [RR ＝0.53，95％CI（0.35，0.80），P＝0.003]. The incidence of overall ADR in trial group with neonatal purulent meningitis [RR ＝0.63，95％CI（0.44，0.92），P＝0.02]，severe neonatal multidrug-resistant bacterial infection [RR ＝0.37，95％CI（0.25， 0.55），P＜0.000 01]，neonatal severe bacterial infection [RR ＝ 0.67，95％CI（0.48，0.94），P＝0.02] were significantly lower than control group. The incidence of specific ADR such as mail： rash，gastrointestinal reaction ，hemoglobin reduction in trialgroup were significantly lower than control group （P＜0.05）. There was no statistical significance in the incidence of specific ADR between 2 groups，such as elevated transaminase ，secondary fungal infection and renal injury （P＞0.05）. Results of bias analysis showed that when the incidence of overall ADR was used as index ，there was a certain degree of publication bias in this study ，when the incidence of specific ADR was used as index ，there was less possibility of publication bias in this study. CONCLUSIONS：Meropenem is safe in the treatment of neonatal infection ，especially in the treatment of neonatal purulent meningitis，severe neonatal multidrug-resistant bacterial infection and neonatal severe bacterial infection ，it is superior to ceftazidime，tigecycline，ceftriaxone and other antibacterial drugs in safety.