Reappraisal of the treatment duration of antibiotic regimens for acute uncomplicated cystitis in adult women: a systematic review and network meta-analysis of 61 randomised clinical trials

荟萃分析 急性膀胱炎 医学 持续时间(音乐) 临床试验 抗生素 内科学 梅德林 系统回顾 重症监护医学 泌尿系统 政治学 微生物学 法学 生物 艺术 文学类
作者
Do Kyung Kim,Jae Heon Kim,Joo Yong Lee,Nam Su Ku,Hye Sun Lee,Juyoung Park,Jong Won Kim,Kwang Joon Kim,Kang Su Cho
出处
期刊:Lancet Infectious Diseases [Elsevier BV]
卷期号:20 (9): 1080-1088 被引量:28
标识
DOI:10.1016/s1473-3099(20)30121-3
摘要

Summary Background Evidence from numerous randomised clinical trials suggest that shorter-term antimicrobial therapy is as effective as—and has other advantages over—longer-term antimicrobial regimens at achieving symptomatic cure for acute uncomplicated cystitis. Nevertheless, not all shorter regimens are adopted in clinical guidelines. This study was done to reappraise the treatment duration of each antibiotic in current guidelines for acute uncomplicated cystitis to investigate whether the regimen lengths of guideline approved antibiotics could be reduced. Methods We systematically searched the PubMed, Embase, and Cochrane Library databases for relevant publications from inception of the databases until Dec 31, 2019. Only randomised clinical trials of women with acute uncomplicated cystitis that assessed antibiotic therapy and reported clinical or microbial response outcome values were included. A network meta-analysis was done and the quality of evidence of all of the included studies was rated. Clinical response was the primary outcome, defined as the complete disappearance of all baseline symptoms at the test-of-cure visit. Bayesian hierarchical random-effects model for dichotomous outcomes was used to compare the efficacy of each antibiotic treatment regimen directly and indirectly. This systematic review is registered in PROSPERO, CRD42018093529. Findings Overall, 61 randomised clinical trials—which included 20 780 patients—were assessed in our systematic review. For the third-generation and fourth-generation fluoroquinolones, a 3-day regimen had similar effect to a single-dose regimen for clinical response (risk ratio [RR] 0·994 [95% credible interval 0·939–1·052] vs 1·024 [0·974–1·083]), with moderate quality of evidence. For pivmecillinam, 5-day and 7-day regimens were similar to a 3-day regimen for clinical response, with moderate quality of evidence (RR 1·041 [0·910–1·193] for the 5-day regimen and 1·095 [0·999–1·203] for the 7-day regimen). Meanwhile, for third-generation cephalosporins and amoxicillin and clavulanate, there was no difference between single-dose and 3-day regimens, but quality of evidence supporting this conclusion was low. For second-generation quinolones and co-trimoxazole, single-dose regimen was less effective than 3-day regimen in clinical response, with moderate quality of evidence. Interpretation Treatment duration of the third-generation and fourth-generation quinolones and pivmecillinam could be shorter than the currently recommended regimens for acute uncomplicated cystitis. For other antibiotics, shorter duration of regimens could be considered, but further research is needed because of the low quality of supporting evidence. Funding None.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Fiona完成签到 ,获得积分10
刚刚
chenchen发布了新的文献求助10
1秒前
1秒前
msy发布了新的文献求助10
1秒前
大胆妖孽完成签到,获得积分10
1秒前
远荒发布了新的文献求助10
2秒前
alefa发布了新的文献求助10
2秒前
bkagyin应助UP采纳,获得10
2秒前
1351567822应助mmt采纳,获得10
3秒前
3秒前
3秒前
3秒前
大个应助山丘采纳,获得10
4秒前
lulubeans完成签到,获得积分10
5秒前
rock发布了新的文献求助10
5秒前
张磊完成签到,获得积分10
5秒前
liuguohua126完成签到,获得积分10
5秒前
琪七发布了新的文献求助10
5秒前
5秒前
625关注了科研通微信公众号
5秒前
方芳芳完成签到,获得积分10
5秒前
5秒前
水木飞雪完成签到,获得积分10
6秒前
封皮人完成签到,获得积分10
6秒前
7秒前
LQ关注了科研通微信公众号
7秒前
kecheng应助汪汪队路马采纳,获得10
8秒前
szh123发布了新的文献求助10
8秒前
8秒前
gj2221423完成签到 ,获得积分10
8秒前
不安的未来完成签到,获得积分10
8秒前
自由山槐发布了新的文献求助10
9秒前
zyy发布了新的文献求助10
9秒前
smottom应助大马哈鱼采纳,获得20
9秒前
千幻发布了新的文献求助10
9秒前
领导范儿应助lqkcqmu采纳,获得30
10秒前
windyTE完成签到,获得积分10
10秒前
SYLH应助负责的雨柏采纳,获得10
11秒前
12秒前
大个应助tt采纳,获得10
13秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3970572
求助须知:如何正确求助?哪些是违规求助? 3515219
关于积分的说明 11177438
捐赠科研通 3250374
什么是DOI,文献DOI怎么找? 1795265
邀请新用户注册赠送积分活动 875750
科研通“疑难数据库(出版商)”最低求助积分说明 805054