ABSTRACT

Background

This systematic review and meta-analysis aimed to investigate the clinical efficacy and safety of novel lipoglycopeptides in treating acute bacterial skin and skin structure infections (ABSSSIs).

Research design and methods

PubMed, Embase, Cochrane Central Register of Controlled Trials, Turning Research into Practice, and ClinicalTrials.gov were searched from inception to 20 May 2021. Randomized controlled trials (RCTs) comparing the clinical efficacy and safety of lipoglycopeptides with other comparators in treating adult patients with ABSSSIs were included. The primary outcome was clinical response.

Results

Eight RCTs (6416 patients; lipoglycopeptides: 3359, comparators: 3057) were enrolled. Clinical response rate was not significantly different between lipoglycopeptides and comparators at early-clinical-evaluation (odds ratio [95% confidence interval]: 1.01 [0.85–1.20], I² = 34%), end-of-treatment (0.94 [0.80–1.11], I² = 0%), and test-of-cure (1.05 [0.85–1.30], I² = 0%). Lipoglycopeptides showed a similar overall microbiological eradication rate (1.12 [0.90–1.38], I² = 21%) but a borderline higher microbiological eradication rate for methicillin-resistant Staphylococcus aureus (1.37 [1.00–1.86], I² = 0%) than the comparators. Lipoglycopeptides were not associated with a higher risk than comparators.

Conclusions

Lipoglycopeptides can achieve similar clinical and microbiological responses to other comparators in treating ABSSSIs. In addition, lipoglycopeptides are as tolerable as their comparators.

中文翻译：

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新型脂糖肽治疗急性细菌性皮肤和皮肤结构感染的临床疗效和安全性：随机对照试验的系统评价和荟萃分析

摘要

背景

本系统评价和荟萃分析旨在研究新型脂糖肽治疗急性细菌性皮肤和皮肤结构感染 (ABSSSI) 的临床疗效和安全性。

研究设计与方法

检索了 PubMed、Embase、Cochrane Central Register of Controlled Trials、Turing Research to Practice 和 ClinicalTrials.gov 从开始到 2021 年 5 月 20 日。比较脂糖肽与其他比较剂治疗成人患者的临床疗效和安全性的随机对照试验 (RCT)包括 ABSSSI。主要结果是临床反应。

结果

纳入了八项随机对照试验（6416 名患者；脂糖肽：3359，比较者：3057）。在早期临床评估（优势比 [95% 置信区间]：1.01 [0.85–1.20]，I ²  = 34%）、治疗结束（0.94 [0.80] –1.11]，I ²  = 0%）和固化试验（1.05 [0.85–1.30]，I ²  = 0%）。脂糖肽显示出相似的总体微生物根除率 (1.12 [0.90–1.38], I ²  = 21%)，但耐甲氧西林金黄色葡萄球菌的微生物根除率略高 (1.37 [1.00–1.86], I ² = 0%）比比较器。与比较剂相比，脂糖肽与更高的风险无关。

结论

脂糖肽在治疗 ABSSSI 时可以达到与其他比较剂相似的临床和微生物学反应。此外，脂糖肽与它们的比较剂一样可耐受。