摘要
Abstract
Objective To evaluate the effectiveness, safety and economy about linezolid versus vancomycin for treatment of Gram-positive cocci infections based on Meta-analysis. Methods The data were collected from the PubMed, MEDLINE, EMBASE, Cochrane library, CNKI, Wanfang, etc through computer. Randomized controlled trials comparing linezolid with vancomycin in patients with Gram-positive cocci infections were eligible for inclusion. Meta-analysis was performed by using RevMan 5.3 software, while cost-effectiveness analysis was used for economic evaluation. Results A total of 8 RCTs were included involving 5322 patients. Meta-analysis results showed that with respect to clinical treatment success, linezolid was more effective than vancomycin in clinically evaluable patients after follow-up period (OR=1.31, 95％ CI:1.08-1.58, Z=2.73, P=0.006).Linezolid also showed clinical efficacy superior to vancomycin in the subgroup of pneumonia (OR=1.32, 95％ CI: 1.02-1.70, P=0.03) or skin and soft-tissue infections (OR=1.48, 95％ CI: 1.06-2.07, P=0.02). There was no difference in clinical success for patients with bacteraemia (OR=1.05, 95％ CI: 0.61-1.81, P=0.85). Although no difference was found regarding the overall incidence of drug-related adverse events (OR=1.00, 95％ CI: 0.87-1.15, P=0.99), there were fewer incidents of abnormal renal function in the linezolid group compared with that in the vancomycin group (OR=0.48, 95％ CI: 0.29-0.78, P=0.004). In addition, thrombocytopenia was recorded more commonly in the linezolid group compared with that in the vancomycin group, having statistical difference (OR=1.86, 95％ CI: 1.20-2.88, P=0.006). The incremental cost-effectiveness ratio was 1220.81. Linezolid group for treatment of Gram-positive cocci infections has better cost-effectiveness than that in vancomycin group under willingness to pay. Conclusion For patients with pneumonia and skin and soft tissue infections caused by Gram-positive cocci infections, linezolid is more economical than vancomycin within the scope of willingness to pay; for patients with bacteremia and sepsis caused by Gram-positive cocci infections, vancomycin is more economical than linezolid in patients with no obvious abnormal renal function.关键词
利奈唑胺/万古霉素/革兰阳性球菌/Meta分析/药物经济学Key words
Linezolid/Vancomycin/Gram-positive cocci/Meta-analysis/Pharmacoeconomic分类
医药卫生
