Efficacy and Safety of Atomization Inhalation of Polymyxin in the Adjunctive Treatment of Ventilator-associated Pneumonia：A Meta-analysis
- VernacularTitle:雾化吸入多黏菌素辅助治疗呼吸机相关性肺炎疗效与安全性的Meta分析
- Author:
Menglin LUO
1
;
Xuan WANG
1
;
Hao BAI
2
;
Wanyi CHEN
2
Author Information
1. Dept. of Pharmacy，the Second Affiliated Hospital of the Army Medical University，Chongqing 400037，China
2. Dept. of Pharmacy，Chongqing University Affiliated Cancer Hospital，Chongqing 400030，China
- Publication Type:Journal Article
- Keywords:
Atomization inhalation;
Polymyxin;
Ventilator-
- From:
China Pharmacy
2021;32(19):2400-2405
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE：To evaluate the efficacy and safety of atomization inhalation of polymyxin combined in the adjunctive treatment for ventilator-associated pneumonia ，and to provide evidence-based reference for clinical treatment. METHODS ： Retrieved from Cochrane Library ，Embase，PubMed，Web of Science ，CNKI，CBM，VIP and Wanfang database （from their inception to March 2021），randomized controlled trials （RCTs）about efficacy and safety of atomization inhalation of polymyxin combined with conventional treatment （trial group ） versus conventional treatment （control group ） for ventilator- associated pneumonia were collected. After data extraction and quality evaluation of included literatures met inclusion and exclusion criteria ， Meta-analysis was performed by using Rev Man 5.4 software. RESULTS ：A total of 13 clinical studies were included ，involving 2 RCTs and 11 cohort studies with a total of 1 066 patients. The results of Meta-analysis showed that clinical response rate [OR ＝ 1.53，95％CI（1.17，2.00），P＝0.002]，microbial clearance rate [OR ＝1.46，95％CI（1.11，1.91），P＝0.007] of trial group were significantly higher than those of control group ，with statistical significance. There was no statistical significance in the mortality rate [OR ＝0.88，95％CI（0.68，1.14），P＝0.32] and the incidence of renal impairment [OR ＝1.04，95％CI（0.72，1.49），P＝0.85] between 2 groups. CONCLUSIONS ：Based on current evidence ，atomization inhalation of polymyxin combined with conventional treatment can significantly improve clinical response rate and microbial clearance rate of patients with ventilator- associated pneumonia. However ， more strictly-designed ， long-term follow-up and large-scale RCTs are needed.
