克拉霉素緩釋片與速釋片治療慢性支氣管炎急性加重期療效的系統評價_《中國循證醫學雜志》

作者：

黃畢林 ¹ ,  胡世蓮 ^1,2 , 沈干 ² , 吳蕾 ² , 徐婷娟 ² , 陳尹 ² , 徐維平 ²

1. 安徽醫科大學附屬省立醫院（合肥?230001）；2. 安徽省循證醫學中心（合肥?230001）;

關鍵詞：

克拉霉素慢性支氣管炎系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20110121

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目的　系統評價并比較克拉霉素緩釋片和速釋片治療慢性支氣管炎急性加重期的有效性和安全性。
方法　計算機檢索Cochrane圖書館（2010年第1期）、PubMed（2000～2010.1）、EMbase（1980～2009.12）、CBM（2000～2010.1）、CNKI（1999～2010.1）和萬方數據庫（2000～2010.1），收集比較克拉霉素緩釋片與速釋片治療慢性支氣管炎急性加重期的隨機對照試驗，由兩名評價員獨立進行文獻篩選、資料提取和質量評價后，采用RevMan 5.0軟件進行Meta分析。
結果　共納入4個RCT，合計2 041例患者，其Jadad評分均≥5分。Meta分析結果顯示兩組臨床治愈率［RR=0.93，95%CI（0.96，1.03）］、病原體清除率［RR=0.99，95%CI（0.94，1.04）］和副反應發生率［RR=1.06，95%CI（0.90，1.25）］的差異均無統計學意義。
結論　現有證據表明，應用克拉霉素緩釋片與克拉霉素速釋片治療慢性支氣管炎急性加重期的患者，其有效性和安全性相當。

引用本文： 黃畢林,胡世蓮,沈干,吳蕾,徐婷娟,陳尹,徐維平. 克拉霉素緩釋片與速釋片治療慢性支氣管炎急性加重期療效的系統評價. 中國循證醫學雜志, 2011, 11(6): 693-697. doi: 10.7507/1672-2531.20110121 復制

1.	2 Gotfried M, Busman TA, Norris S, et al . Role for 5-day, once-daily extended-release clarithromycin in acute bacterial exacerbation of chronic bronchitis. Curr Med Res Opin , 2007, 23(2): 459-466.
2.	3 Williams KN, Bishai WR. Clarithromycin extended-release in community-acquired respiratory tract infections. Expert Opin Pharmacother , 2005, 6(16): 2867-2876.
3.	4 Gotfried M, Notario G, Spiller J, et al . Comparative efficacy of once daily, 5-day short-course therapy with clarithromycin extended-release versus twice daily, 7-day therapy with clarithromycin immediate-release in acute bacterial exacerbation of chronic bronchitis. Curr Med Res Opin , 2005, 21(2): 245-254.
4.	5 Nalepa P, Dobryniewska M, Busman T, et al . Short-course therapy of acute bacterial exacerbation of chronic bronchitis: a double-blind, randomized, multicenter comparison of extended-release versus immediate-release clarithromycin. Curr Med Res Opin , 2003, 19(5): 411-420.
5.	6 Weiss K, Vanjaka A; Canadian Clarithromycin Study Group on Bronchitis. An open-label, randomized, multicenter, comparative study of the efficacy and safety of 7 days of treatment with clarithromycin extended-release tablets versus clarithromycin immediate-release tablets for the treatment of patients with acute bacterial exacerbation of chronic bronchitis. Clin Ther , 2002, 24(12): 2105-2122.
6.	8 Jadad AR, Moore RA, Carroll D, et al . Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials , 1996, 17(1): 1-12.
7.	9 Adler JL, Jannetti W, Schneider D, et al . Phase III, randomized, double-blind study of clarithromycin extended-release and immediate-release formulations in the treatment of patients with acute exacerbation of chronic bronchitis. Clin Ther , 2000, 22(12): 1410-1420.
8.	11 Kardas P. Comparison of patient compliance with once-daily and twice-daily antibiotic regimens in respiratory tract infections: results of a randomized trial. J Antimicrob Chemother , 2007, 59(3): 531-536.
9.	吳嵐. 大環內酯類抗生素的抗炎活性. 國外醫學呼吸系統分冊, 2002, 22(2): 108-110.
10.	孟茂斌, 崔堯麗, 官詠松, 等. 中藥配合肝動脈栓塞化療治療原發性肝癌隨機對照試驗的Meta分析. 中國循證醫學雜志, 2008, 8(1): 21-31.
11.	鐘梅, 李文輝. 克拉霉素分散片治療下呼吸道感染80例觀察. 社區醫學雜志, 2006, 4(14): 26-27.

1. 2 Gotfried M, Busman TA, Norris S, et al . Role for 5-day, once-daily extended-release clarithromycin in acute bacterial exacerbation of chronic bronchitis. Curr Med Res Opin , 2007, 23(2): 459-466.
2. 3 Williams KN, Bishai WR. Clarithromycin extended-release in community-acquired respiratory tract infections. Expert Opin Pharmacother , 2005, 6(16): 2867-2876.
3. 4 Gotfried M, Notario G, Spiller J, et al . Comparative efficacy of once daily, 5-day short-course therapy with clarithromycin extended-release versus twice daily, 7-day therapy with clarithromycin immediate-release in acute bacterial exacerbation of chronic bronchitis. Curr Med Res Opin , 2005, 21(2): 245-254.
4. 5 Nalepa P, Dobryniewska M, Busman T, et al . Short-course therapy of acute bacterial exacerbation of chronic bronchitis: a double-blind, randomized, multicenter comparison of extended-release versus immediate-release clarithromycin. Curr Med Res Opin , 2003, 19(5): 411-420.
5. 6 Weiss K, Vanjaka A; Canadian Clarithromycin Study Group on Bronchitis. An open-label, randomized, multicenter, comparative study of the efficacy and safety of 7 days of treatment with clarithromycin extended-release tablets versus clarithromycin immediate-release tablets for the treatment of patients with acute bacterial exacerbation of chronic bronchitis. Clin Ther , 2002, 24(12): 2105-2122.
6. 8 Jadad AR, Moore RA, Carroll D, et al . Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials , 1996, 17(1): 1-12.
7. 9 Adler JL, Jannetti W, Schneider D, et al . Phase III, randomized, double-blind study of clarithromycin extended-release and immediate-release formulations in the treatment of patients with acute exacerbation of chronic bronchitis. Clin Ther , 2000, 22(12): 1410-1420.
8. 11 Kardas P. Comparison of patient compliance with once-daily and twice-daily antibiotic regimens in respiratory tract infections: results of a randomized trial. J Antimicrob Chemother , 2007, 59(3): 531-536.
9. 吳嵐. 大環內酯類抗生素的抗炎活性. 國外醫學呼吸系統分冊, 2002, 22(2): 108-110.
10. 孟茂斌, 崔堯麗, 官詠松, 等. 中藥配合肝動脈栓塞化療治療原發性肝癌隨機對照試驗的Meta分析. 中國循證醫學雜志, 2008, 8(1): 21-31.
11. 鐘梅, 李文輝. 克拉霉素分散片治療下呼吸道感染80例觀察. 社區醫學雜志, 2006, 4(14): 26-27.

《中國循證醫學雜志》

克拉霉素緩釋片與速釋片治療慢性支氣管炎急性加重期療效的系統評價

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《中國循證醫學雜志》

克拉霉素緩釋片與速釋片治療慢性支氣管炎急性加重期療效的系統評價

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