Telithromycin versus clarithromycin for the treatment of community-acquired respiratory tract infections: a meta-analysis of randomized controlled trials / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 2179-2185, 2013.
Article
Dans En
| WPRIM
| ID: wpr-273015
Responsable en Bibliothèque :
WPRO
ABSTRACT
<p><b>BACKGROUND</b>The emergence of bacterial resistance to commonly used antibiotics, such as macrolides, is complicating the management of respiratory tract infections (RTIs). Telithromycin, a ketolide antimicrobial structurally related to macrolides, is approved for the treatment of community-acquired RTIs, and shows lower pathogen resistance rates. The purpose of this study was to compare the efficacy and safety of telithromycin with clarithromycin, a macrolide routinely used as therapy for RTIs.</p><p><b>METHODS</b>We performed a meta-analysis of relevant randomized-controlled trials (RCTs) identified in PubMed, the Cochrane Library, Embase, CNKI and VIP databases. The primary efficacy outcome was clinical treatment success assessed at the test-of-cure time in the per-protocol population, and the primary safety outcome was drug related adverse effects.</p><p><b>RESULTS</b>Seven RCTs, involving 2845 patients with RTIs, were included in the meta-analysis. Oral telithromycin and clarithromycin showed a similar clinical treatment success in modified intention to treat and per-protocol population (cure and improvement) (odds ratios (ORs) 0.84, 95% confidence intervals (CI) 0.64 - 1.11 and OR 1.14, 95%CI 0.71 - 1.85, respectively). Similar findings were obtained for secondary efficacy outcomes:
clinical treatment success at a late post-therapy visit (OR 0.92, 95%CI 0.57 - 1.48) and microbiological treatment success at the test-of-cure time (OR 1.14; 95%CI 0.71 - 1.85). The safety outcome analysis indicated telithromycin had a similar risk of drug-related adverse effect and serious adverse effect with clarithromycin.</p><p><b>CONCLUSIONS</b>Our findings indicate that oral telithromycin and clarithromycin have similar treatment efficacy and adverse effect. The advantages of lower antimicrobial resistance rates, once-daily short-duration dosing and reported lower health-care costs make oral telithromycin a useful option for the empiric management of mild-to-moderate RTIs.</p>
Texte intégral:
1
Indice:
WPRIM
Sujet Principal:
Infections de l'appareil respiratoire
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Essais contrôlés randomisés comme sujet
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Clarithromycine
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Infections communautaires
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Utilisations thérapeutiques
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Cétolides
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Traitement médicamenteux
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Antibactériens
Type d'étude:
Clinical_trials
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Guideline
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Prognostic_studies
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Systematic_reviews
Limites du sujet:
Humans
langue:
En
Texte intégral:
Chinese Medical Journal
Année:
2013
Type:
Article