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克林霉素注射剂不良反应的Meta分析
潘晨,彭联威,邹慧龙
作者单位
潘晨 丽水市人民医院药学部 
彭联威  
邹慧龙  
摘要:
目的采用Meta分析评价克林霉素注射剂临床应用的不良反应。方法检索《中国期刊全文数据库》、维普资讯《中文科技期刊数据库》、《万方数据医学信息系统》2009至2014年期间发表的有关克林霉素注射剂的不良反应的报道,对纳入的文献进行评价,采用RevMan5.2软件,对符合标准的文献中克林霉素注射剂的不良反应发生率进行Meta分析。同时对不同适应证(成人呼吸系统感染、小儿及儿童支原体肺炎、盆腔炎、产后子宫内膜炎),不同年龄(儿童≤15岁、成人≥16岁),不同剂型(盐酸盐、磷酸酯),不同剂量[<20mg/(kg·d)、20~60mg/(kg·d)、>60mg/(kg·d)],不同疗程(<7d、7d、>7d),不同合并用药(阿奇霉素、庆大霉素、无合并用药)的不良反应发生率进行亚组分析。结果符合标准的29篇文献纳入研究。Meta分析结果显示,克林霉素注射剂组的不良反应发生率(OR=0.40,95%CI:0.32~0.50,P<0.01)明显低于对照组。在合并用药中阿奇霉素亚组(OR=0.73,95%CI:0.43~1.23,P=0.23)中,治疗组和对照组不良反应发生率的差异无统计学意义,余合并用药亚组、其余亚组中,克林霉素注射剂组的不良反应发生率均明显低于对照组。结论近几年克林霉素注射剂应用于感染性疾病时不良反应发生率较高,特别是静脉应用时,临床上应引起重视,做到合理用药。
关键词:  克林霉素 不良反应 Meta 分析 临床随机对照研究
DOI:10.12056/j.issn.1006-2785.2017.39.15.2016-1166
分类号:
基金项目:2013年浙江省药学会医院药学专项科研资助项目(2013ZYY18)
Adverse effects of clindamycin injection: a meta-analysis
PAN Chen,PENG Lianwei,ZOU Huilong
Abstract:
Objective To evaluate the adverse effects of clindamycin injection by meta-analysis. Methods The databases of CNKI, VIP and Wanfang were searched for randomized controlled clinical trials related to clindamycin injection, which were published between 2009 and 2014. Revman5.2 software was used to conduct meta-analysis for the rate of adverse reaction of clindamycin injection. Meanwhile, adverse effects were analyzed by stratification of different indications (adult respiratory system infection, children mycoplasma pneumonia, pelvic inflammatory disease, postpartum endometritis), different ages (<16 years and ≥16 years), different dosage forms (hydrochloride, phosphate), different doses (≤20 mg/kg•d, 20-60mg/kg•d, >60 mg/kg•d), different course of treatment(<7d, =7d, >7d) and different combinations of drugs (azithromycin, gentamicin, no combined medication). Results Twenty nine studies involving 2581 patients were included in the analysis, patients treated with azithromycin, penicillin and levofloxacin served as the control group. The main adverse reactions were rash, nausea, vomiting, abdominal pain, diarrhea, liver dysfunction, hand and foot twitching. Meta analysis results showed that the overall rate of adverse reaction in clindamycin injection group was 10.85% and that in control group was 23.04% (OR=0.40, 95%CI:0.32~0.50, P<0.01). There was no significant difference in adverse effects between clindamycin group and control group in combination with azithromycin (OR=0.73, 95%CI:0.43~1.23, P=0.23). The adverse effect rates of clindamycin group were all lower than those of control group in other stratification subgroups. Conclusion Clindamycin injection is used in infectious diseases with low incidence of adverse reactions and good safety.
Key words:  Clindamycin injection Adverse reaction Meta analysis Randomized controlled clinical study