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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Extended-Interval Aminoglycoside Therapy for Adult Patients with Febrile Neutropenia: A Systematic Review
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Extended-Interval Aminoglycoside Therapy for Adult Patients with Febrile Neutropenia: A Systematic Review

机译：成年发热性中性粒细胞减少症患者的延长间隔氨基糖苷治疗：系统评价

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Background: Although the efficacy and toxicity of extended-interval (once-daily) aminoglycoside regimens is well established for immuno-competent patients, there is clinical concern about using this regimen for patients with neutropenia.Objective: To summarize and evaluate the literature reporting the clinical efficacy and safety of extended-interval aminoglycosides therapy in adults with febrile neutropenia.Methods: A literature search was conducted within PubMed, Embase, and the Cochrane Database of Systematic Reviews to identify studies assessing the use of extended-interval aminoglycosides for treating febrile neutropenia in adults. Articles were categorized by quality of evidence, according to the rating scale of the US Preventive Services Task Force.Results: Ten articles were identified: 5 with level I evidence, 1 with level II-2 evidence, and 4 with level III evidence. Review of the 5 studies with level I evidence (all open-label randomized controlled trials), which compared extended-interval dosing with multiple-daily dosing strategies, revealed no evidence to suggest superiority of one regimen over the other in terms of clinical outcomes. In the study with level II-2 evidence (a prospecdve comparative trial), the response rate was better in the extended-interval group than in the standard-therapy group. Two of the studies with level III evidence (both prospective noncomparative trials) also had acceptable response rates to extended-interval aminoglycoside therapy, with minimal associated nephrotoxicity. In this review, no major differences in rates of nephrotoxicity or ototoxicity were seen between the 2 dosing regimens.Conclusions: The use of extended-interval dosing for aminoglycosides, in combination with other recommended antibiotic therapy, is an effective and safe management strategy for immunocompromised patients with febrile neutropenia. In this population, the clinical efficacy and safety of extended-interval dosing does not appear to differ fro...
机译：背景：尽管延长间隔的（每日一次）氨基糖苷方案对于具有免疫功能的患者已确立了疗效和毒性，但仍存在针对中性粒细胞减少症患者使用该方案的临床问题。目的：总结和评估报道该文献的文献方法：在成人发热性中性粒细胞减少症中延长间隔氨基糖苷治疗的临床疗效和安全性。方法：在PubMed，Embase和Cochrane系统评价数据库中进行文献检索，以鉴定评估使用延长间隔氨基糖苷治疗高热性中性粒细胞减少症的研究在成人中。根据美国预防服务工作队的评分标准，对文章按证据质量进行分类。结果：确定了10篇文章：5篇为I级证据，1篇为II-2级证据，4篇为III级证据。回顾了5项具有I级证据的研究（所有开放标签随机对照试验），该研究将延长间隔给药与每日给药策略进行了比较，发现没有证据表明一种方案在临床结局方面优于另一种方案。在具有II-2级证据的研究中（一项有希望的比较试验），延长间隔组的缓解率优于标准疗法组。两项具有III级证据的研究（均为前瞻性非比较试验）也对延长间隔的氨基糖苷疗法具有可接受的缓解率，且肾毒性最小。在这篇综述中，两种给药方案之间的肾毒性或耳毒性率没有显着差异。高热性中性粒细胞减少症患者。在这个人群中，延长间隔给药的临床疗效和安全性似乎在不同人群之间没有区别。

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