A meta-analysis of Metronidazole for Clostrdium difficile-associated diarrhea in adults
The aim of this meta-analysis was to investigate the efficacy of metronidazole for treatment of Clostridium difficile associated diarrhea (CDAD).A meta-analysis of randomized controlled trials (RCTs) and cohort studies identified in Pubmed,Embase and the Cohrane Library was performed.Five RCTsand two cohort studies involving 1012 patients were included.Compared with therapy with antibiotic monotherapy regimens for CDAD patients,metronidazole was associated with similar clinical treatment success of vancomycinfor mild CDAD patients(odds ratio,OR=0.59,95% CI = 0.27 to 1.26,P=0.17),but metronidazole was inferior to vancomycin for severe CDAD patients(OR=0.17,95% CI = 0.04 to 0.66,P=0.01).Metronidazole was as clinically effective as fusidic acid(OR=2.08 95% CI=0.74 to 5.82,P=0.16).No statisticaldifferences in relapse rate were found between metronidazole and active comparators as a whole(OR=1.06,95% CI=0.75 to 1.51,P=0.73),metronidazole and vancomycin(OR=1.02,95% CI=0.65 to 1.62,P=0.82),metronidazole and fusidic acid (OR=0.77,95% CI=0.38 to 1.55,P=0.43).Regarding all-cause mortality and drug related adverse effects(AEs),no differenceswere found between metronidazole and vancomycin(mortality,OR=1.54,95% CI = 0.62 to 3.82,P=0.35),metronidazole and fusidic acid (AEs,OR=0.69,95% CI = 0.09 to 5.11,P=0.72).In conclusion,patients tolerated all the drugs equally well andrelapse rates were similar.The datasuggest that metronidazole may be used as effectively as fusidic acid,and as vancomycin for mild CDAD patients,but is inferior to vancomycinfor severe CDAD patients.Oral metronidazole is still widely used.
Xiuzhen Di Rui Wang Jin Wang Kai Wang Xin Zhang Bin Liu Youning Liu
Center for Clinical Pharmaceutical Research,Chinese People”s Liberation Army General Hospital,Beijin Department of Respiratory Diseases,Chinese People”s Liberation Army General Hospital,Beijing,PR Chin
国内会议
石家庄
英文
1-19
2014-10-24（万方平台首次上网日期，不代表论文的发表时间）