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Cilostazol for the prevention of pneumonia: a systematic review

机译：西洛他唑预防肺炎：系统评价

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Background Pneumonia is a very common disease, especially among the elderly. Various drugs’ preventive effects against pneumonia have been reported. The antiplatelet drug cilostazol is used to prevent pneumonia, but the robustness of its efficacy is unclear. This review estimates the effectiveness of cilostazol for preventing pneumonia in elderly individuals. Methods The following databases were searched from the earliest record to January 2016, without language restriction (the secondary search was conducted on February 2017): MEDLINE, Cochrane Library, CINAHL, and Ichushi-Web. Studies were included if they were published randomized controlled trials investigating the preventive effect of cilostazol on pneumonia in the elderly. The outcome was the incidence of pneumonia. Results Two trials were identified that met the search criteria (1423 participants). Both trials compared cilostazol with no antiplatelet in patients with a history of cerebral infarction. A meta-analysis was not performed because of the small number of trials and the heterogeneity of the data. Both trials suggested that cilostazol reduced the incidence of pneumonia (risk ratio [RR] 0.40; 95% confidence interval [CI] 0.22–0.73 in one trial, RR 0.20; 95% CI 0.06–0.69 in the other) and the recurrence of cerebral infarction (0.43; 0.21–0.90, 0.53; 0.34–0.81, respectively). The quality of evidence provided by the trials was very low, mainly because of the high risk of bias. Conclusions It is difficult to draw conclusions on the basis of two trials. Moreover, in the two trials, cilostazol could have reduced the incidence of pneumonia via a reduction of the recurrence of cerebral infarction, which suggests that other antiplatelets could also have the same effects. Stronger evidence is required from large trials assessing the effectiveness of cilostazol for the prevention of pneumonia. Trial registration PROSPERO ( CRD42016036724 ).
机译：背景肺炎是一种非常常见的疾病，尤其是在老年人中。据报道，多种药物对肺炎有预防作用。抗血小板药西洛他唑用于预防肺炎，但其有效性的鲁棒性尚不清楚。该评价评估了西洛他唑预防老年人肺炎的有效性。方法从最早的记录到2016年1月，没有语言限制地搜索了以下数据库（二次搜索于2017年2月进行）：MEDLINE，Cochrane图书馆，CINAHL和Ichushi-Web。如果发表了研究西洛他唑对老年人肺炎的预防作用的随机对照试验，则包括这些研究。结果是肺炎的发生率。结果确定了两项符合检索标准的试验（1423名参与者）。两项试验均对有脑梗死史的西洛他唑不加抗血小板药物进行了比较。由于试验次数少和数据的异质性，未进行荟萃分析。两项试验均提示西洛他唑可降低肺炎的发生率（一项试验的风险比[RR]为0.40; 95％的置信区间[CI]为0.22-0.73;另一项试验为RR 0.20; 95％的CI为0.06-0.69）和脑复发梗死（分别为0.43; 0.21-0.90，0.53; 0.34-0.81）。试验提供的证据质量很低，主要是因为存在较高的偏见风险。结论很难根据两项试验得出结论。此外，在这两项试验中，西洛他唑可以通过减少脑梗死的复发来降低肺炎的发生率，这表明其他抗血小板药也可能具有相同的作用。评估西洛他唑预防肺炎有效性的大型试验需要更强有力的证据。试用注册PROSPERO（CRD42016036724）。

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