ABSTRACT
OBJECTIVE To systematically evaluate the risk factors for cefoperazone/sulbactam-induced coagulation dysfunction in adult patients. METHODS Retrieved from CNKI， VIP， CBM， Wanfang data， PubMed， Embase and Cochrane Library， randomized controlled trial （RCT）， case-control study or cohort study about cefoperazone/sulbactam-induced coagulation dysfunction in adult patients were collected from the inception to Apr. 30th， 2023. After literature screening， data extraction and quality evaluation， meta-analysis was carried out by using RevMan 5.3 software. RESULTS A total of 13 studies were included， among which 11 studies were case-control studies， and 2 studies were cohort studies， involving 18 387 patients in total. Meta- analysis showed that the proportion of advanced age [OR＝2.04， 95%CI （1.14， 3.64）， P＝0.02]， liver insufficiency [OR＝5.95， 95%CI （4.21， 8.40）， P＜0.000 01]， renal insufficiency [OR＝3.51， 95%CI （3.04， 4.05）， P＜0.001]， hypoproteinemia [OR＝ 1.90， 95%CI（1.37， 2.62）， P＜0.001]， poor diet [OR＝7.25， 95%CI （5.13， 10.24）， P＜0.000 01]， daily dose of cefoperazone/ sulbactam ≥9 g [OR＝3.95， 95%CI （2.45，6.37）， P＜0.001]， medication duration of cefoperazone/sulbactam ≥10 d [OR＝2.43， 95%CI （1.81， 3.28）， P＜0.001]， combined use of anticoagulant drugs [OR＝2.84， 95%CI （2.03， 3.97）， P＜0.001]， combined with malignant tumor [OR＝1.60， 95%CI （1.20， 2.15），P＜0.001] in patients with abnormal coagulation function were significantly higher than those with normal coagulation function. CONCLUSIONS Advanced age， liver insufficiency， renal insufficiency， complicated with malignant tumors and hypoalbuminemia， combined use of anticoagulant drugs， poor diet， daily dose ≥9 g， and medication duration≥10 days are risk factors for coagulation dysfunction caused by cefoperazone/sulbactam.
ABSTRACT
OBJECTIVE:To systematically review the clinical efficacy and safety of macrolide antimicrobial drugs in the adju-vant treatment of lung infection of Pseudomonas aeruginosa (PA) and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Ovid,CJFD,VIP,CBM and Wangfang database,randomized controlled trials(RCT)about sensitive antimicrobial drugs of PA combined with macrolide antimicrobial drugs (test group) vs. sensitive antimicrobial drugs of PA alone(control group)in the treatment of lung infection of PA were included and comprehensively evaluated using Jadad scale. The homogeneity results were analyzed by Rev Man 5.2 software. RESULTS:13 RCTs were included,involving 872 patients. Me-ta-analysis showed that the effective rate [OR=6.42,95%CI(4.23,9.74),P<0.001] and PA clearance rate[OR=6.10,95%CI(4.10, 9.09),P<0.001] in test group were significantly higher than control group;the time of body temperature returned to normal[MD=-1.14,95%CI(-1.35,-0.94),P<0.001],time of cough sputum disappearance [MD=-1.70,95%CI (-1.97,-1.44),P<0.001] and time of the blood returned to normal[MD=-1.24,95%CI(-2.04,-0.43),P<0.001] were significantly shorter than control group,there were significant difference between 2 groups. There was no significant difference in the incidence of adverse re-action [OR=1.30,95%CI(0.73,2.31),P=0.37]. CONCLUSIONS:Macrolide antimicrobial drugs have good efficacy and safety in the adjuvant treatment of PA infection. Duo to the limit of research methodology quality,it remains to be further verified by large-sample and high-quality RCT.