Efficacy and Safety of Teicoplanin versus Vancomycin for Lower Respiratory Tract Infection with Gram-positive Bacteria in Chinese Population: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 TAOHua ^1,2 , CHENGXiao-ke ³ , WANGJuan ² , DONGQing-yu ⁴ , ZHOULi-na ⁵

1. Department of Quality and Efficacy Statistics, Zhengzhou Second Hospital, Zhengzhou 450006, China;
2. Department of Pharmacy, Zhengzhou Second Hospital, Zhengzhou 450006, China;
3. Center for Evidence-Based Medicine, Huaihe Hospital of Henan University, Kaifeng, Henan 475000, China;
4. Department of Nursing, Zhengzhou Second Hospital, Zhengzhou 450006, China;
5. Department of Respiratory Diseases, Zhengzhou Second Hospital, Zhengzhou 450006, China;

Corresponding author：

Keywords：

Teicoplanin; Vancomycin; Lower respiratory tract infection; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160125

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically evaluate the efficacy and safety of teicoplanin versus vancomycin for lower respiratory tract infection with gram-positive bacteria in Chinese population. Methods The PubMed, EMbase, The Cochrane Library (Issue 3, 2016), CNKI, and WanFang Data databases were searched from their inception to March 20, 2016, to collect randomized controlled trials about teicoplanin versus vancomycin for lower respiratory tract infection with gram-positive bacteria in Chinese population. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 12 RCTs involving 921 patients were included. The results of meta-analysis suggested that there were no significant associations between the teicoplanin group and the vancomycin group in total effective rate (RR=0.99, 95%CI 0.93 to 1.05, P=0.69), clinical cure rate (RR=1.05, 95%CI 0.92 to 1.19, P=0.49), and bacteria clearance rate (RR=1.00, 95%CI 0.93 to 1.05, P=0.69). However, the teicoplanin group had lower incidences of the total adverse event (RR=0.65, 95%CI 0.47 to 0.90, P=0.008) and nephrotoxicity (RR=0.33, 95%CI 0.16 to 0.66, P=0.002), and shorter course of treatment (MD=-1.78, 95%CI -3.27 to -0.29, P=0.02) than that in the vancomycin group. Conclusion Current evidence indicates that teicoplanin is similar to vancomycin in therapeutic effects on treating lower respiratory tract infection with gram-positive bacteria in Chinese population, but teicoplanin is better in safety and has a shorter course of treatment than vancomycin. Due to limited quantity and quality of the included studies, more high-quality RCTs are needed to confirm the above conclusions.

Citation： TAOHua, CHENGXiao-ke, WANGJuan, DONGQing-yu, ZHOULi-na. Efficacy and Safety of Teicoplanin versus Vancomycin for Lower Respiratory Tract Infection with Gram-positive Bacteria in Chinese Population: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(7): 809-818. doi: 10.7507/1672-2531.20160125 Copy

1.	李春辉, 吴安华, 黄昕, 等. 耐甲氧西林金黄色葡萄球菌分子流行病学研究. 中华医院感染学杂志, 2009, 19(9):1032-1035.
2.	茆海丰, 邵世和, 杨晋, 等. 耐甲氧西林金黄色葡萄球菌SCCmec基因分型研究与耐药基因检测. 中华医院感染学杂志, 2010, 20(1):12-15.
3.	张杏怡, 何礼贤, 胡必杰, 等. 耐甲氧西林金黄色葡萄球菌的耐药性研究. 中华医院感染学杂志, 1996, 6(2):114-116.
4.	李艳, 刘晓阳. 替考拉宁的临床应用进展及安全性评价. 中国医院药学杂志, 2008, 28(12):1015-1017.
5.	Li S, Kwong JS, Zeng XT, et al. Plasmakinetic resection technology for the treatment of benign prostatic hyperplasia:evidence from a systematic review and meta-analysis. Sci Rep, 2015, 5:12002.
6.	Li S, Zeng XT, Ruan XL, et al. Holmium laser enucleation versus transurethral resection in patients with benign prostate hyperplasia:an updated systematic review with meta-analysis and trial sequential analysis. PLoS One, 2014, 9(7):e101615.
7.	曾宪涛, 冷卫东, 郭毅, 等. Meta分析系列之一:Meta分析的类型. 中国循证心血管医学杂志, 2012, 4(1):3-5.
8.	曾宪涛, 田国祥, 张超, 等. Meta分析系列之十五:Meta分析的进展与思考. 中国循证心血管医学杂志, 2013, 5(6):561-563.
9.	曾宪涛, 邝心颖, 孙燕, 等. 什么是循证医学?. 湖北医药学院学报, 2013, 32(1):1-5.
10.	曾宪涛, 熊期, 沈可. Meta分析系列之十三:盲法的评价. 中国循证心血管医学杂志, 2013, 5(4):331-333.
11.	曾宪涛, 黄伟, 沈可. Meta分析系列之十一:随机化的评价. 中国循证心血管医学杂志, 2013, 5(2):101-103.
12.	曾宪涛, 包翠萍, 曹世义, 等. Meta分析系列之三:随机对照试验的质量评价工具. 中国循证心血管医学杂志, 2012, 4(3):183-185.
13.	曾宪涛, 沈可, 罗杰. Meta分析系列之十二:分配隐藏的评价. 中国循证心血管医学杂志, 2013, 5(3):219-221.
14.	Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. Available at:www.cochrane-handbook.org.
15.	Zeng X, Zhang Y, Kwong JS, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline:a systematic review. J Evid Based Med, 2015, 8(1):2-10.
16.	Higgins J, Thompson S. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11):1539-1559.
17.	Egger M, Smith GD, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7129):629-634.
18.	曾宪涛, Joey S. W. Kwong, 田国祥, 等. Meta分析系列之二:Meta分析的软件. 中国循证心血管医学杂志, 2012, 4(2):89-91.
19.	吕芳芳, 王慧玲. 替考拉宁与万古霉素随机对照多中心临床研究. 中国临床药理学杂志, 2002, 18(4):243-246.
20.	朱惠莉, 龚瑾, 符礼刚, 等. 替考拉宁与万古霉素治疗老年人耐甲氧西林金葡菌肺部感染的评价. 中国临床医学, 2003, 10(2):183-185.
21.	徐赤裔, 金雨虹, 陈东妹. 万古霉素与替考拉宁治疗老年MRSA/MRSE肺部感染的疗效比较. 现代实用医学, 2006, 18(9):656-657.
22.	彭红, 瞿云中, 陈平. 替考拉宁治疗下呼吸道感染革兰阳性球菌的疗效和安全性评价. 中华医院感染学杂志, 2009, 19(16):2172-2175.
23.	孙晓霞, 方巍, 孙运波. 万古霉素和替考拉宁治疗ICU耐甲氧西林金黄色葡萄球菌感染的评价. 齐鲁医学杂志, 2009, 24(6):533-534.
24.	董樑, 陈小东. 替考拉宁与万古霉素治疗MRSA下呼吸道感染的疗效与安全性评价. 中华医院感染学杂志, 2010, 20(5):711-713.
25.	谢续标, 叶明佶, 彭龙开, 等. 国产替考拉宁与进口万古霉素治疗肾移植术后革兰阳性球菌肺部感染的评价. 中华医院感染学杂志, 2010, 20(15):2296-2298.
26.	单联斌, 王超. 替考拉宁治疗革兰氏阳性球菌肺炎的疗效. 中国实用医刊, 2012, 38(20):115-116.
27.	童皖宁, 卓安山, 曹玉书, 等. 几种常用抗MRSA药物在老年患者肺部感染中的疗效比较. 临床军医杂志, 2015, 41(2):124-127.
28.	谭永峰, 冯星火, 王春. 替考拉宁治疗呼吸机相关性肺炎疗效与安全性评价. 中华医院感染学杂志, 2014, 24(11):2678-2682.
29.	许敬菊. 替考拉宁与万古霉素治疗耐甲氧西林金黄色葡萄球菌肺炎的疗效比较. 中国基层医药, 2014, 21(16):2416-2417.
30.	朱婉凌, 刘艳红, 于洪涛, 等. 替考拉宁治疗慢性阻塞性肺疾病患者革兰阳性菌感染的临床研究. 中华医院感染学杂志, 2014, 24(23):5820-5822.
31.	冯学仁, 陆华东, 崔恩海. 不同剂量替考拉宁治疗耐甲氧西林金黄色葡萄球菌感染呼吸机相关性肺炎的疗效研究. 中华医院感染学杂志, 2014, 24(2):349-351.
32.	刘绍霞, 李金红. 不同剂量替考拉宁治疗重症医院获得性肺炎疗效观察及安全性评价. 中华医院感染学杂志, 2012, 22(17):3841-3843.
33.	杨睿, 鲁新华, 张国俊. 不同起始负荷剂量替考拉宁治疗革兰阳性菌下呼吸道感染的疗效与安全性评价. 中华医院感染学杂志, 2015, 25(20):4673-4675.
34.	林春燕, 刘晓妍, 刘升明. 利奈唑胺对比糖肽类抗菌药物治疗MRSA相关性院内获得性肺炎的疗效和安全性的Meta分析. 中国药房, 2014, 25(20):1900-1903.
35.	石庆平, 丁峰, 刘雁, 等. 替考拉宁与万古霉素治疗革兰阳性菌感染疗效和安全性评价. 中国医院药学杂志, 2012, 32(7):535-539.
36.	Gould FK, Brindle R, Chadwick PR, et al. Guidelines (2008) for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the United Kingdom. J Antimicrob Chemother, 2009, 63(5):849-861.

1. 李春辉, 吴安华, 黄昕, 等. 耐甲氧西林金黄色葡萄球菌分子流行病学研究. 中华医院感染学杂志, 2009, 19(9):1032-1035.
2. 茆海丰, 邵世和, 杨晋, 等. 耐甲氧西林金黄色葡萄球菌SCCmec基因分型研究与耐药基因检测. 中华医院感染学杂志, 2010, 20(1):12-15.
3. 张杏怡, 何礼贤, 胡必杰, 等. 耐甲氧西林金黄色葡萄球菌的耐药性研究. 中华医院感染学杂志, 1996, 6(2):114-116.
4. 李艳, 刘晓阳. 替考拉宁的临床应用进展及安全性评价. 中国医院药学杂志, 2008, 28(12):1015-1017.
5. Li S, Kwong JS, Zeng XT, et al. Plasmakinetic resection technology for the treatment of benign prostatic hyperplasia:evidence from a systematic review and meta-analysis. Sci Rep, 2015, 5:12002.
6. Li S, Zeng XT, Ruan XL, et al. Holmium laser enucleation versus transurethral resection in patients with benign prostate hyperplasia:an updated systematic review with meta-analysis and trial sequential analysis. PLoS One, 2014, 9(7):e101615.
7. 曾宪涛, 冷卫东, 郭毅, 等. Meta分析系列之一:Meta分析的类型. 中国循证心血管医学杂志, 2012, 4(1):3-5.
8. 曾宪涛, 田国祥, 张超, 等. Meta分析系列之十五:Meta分析的进展与思考. 中国循证心血管医学杂志, 2013, 5(6):561-563.
9. 曾宪涛, 邝心颖, 孙燕, 等. 什么是循证医学?. 湖北医药学院学报, 2013, 32(1):1-5.
10. 曾宪涛, 熊期, 沈可. Meta分析系列之十三:盲法的评价. 中国循证心血管医学杂志, 2013, 5(4):331-333.
11. 曾宪涛, 黄伟, 沈可. Meta分析系列之十一:随机化的评价. 中国循证心血管医学杂志, 2013, 5(2):101-103.
12. 曾宪涛, 包翠萍, 曹世义, 等. Meta分析系列之三:随机对照试验的质量评价工具. 中国循证心血管医学杂志, 2012, 4(3):183-185.
13. 曾宪涛, 沈可, 罗杰. Meta分析系列之十二:分配隐藏的评价. 中国循证心血管医学杂志, 2013, 5(3):219-221.
14. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0[updated March 2011]. Available at:www.cochrane-handbook.org.
15. Zeng X, Zhang Y, Kwong JS, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline:a systematic review. J Evid Based Med, 2015, 8(1):2-10.
16. Higgins J, Thompson S. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11):1539-1559.
17. Egger M, Smith GD, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7129):629-634.
18. 曾宪涛, Joey S. W. Kwong, 田国祥, 等. Meta分析系列之二:Meta分析的软件. 中国循证心血管医学杂志, 2012, 4(2):89-91.
19. 吕芳芳, 王慧玲. 替考拉宁与万古霉素随机对照多中心临床研究. 中国临床药理学杂志, 2002, 18(4):243-246.
20. 朱惠莉, 龚瑾, 符礼刚, 等. 替考拉宁与万古霉素治疗老年人耐甲氧西林金葡菌肺部感染的评价. 中国临床医学, 2003, 10(2):183-185.
21. 徐赤裔, 金雨虹, 陈东妹. 万古霉素与替考拉宁治疗老年MRSA/MRSE肺部感染的疗效比较. 现代实用医学, 2006, 18(9):656-657.
22. 彭红, 瞿云中, 陈平. 替考拉宁治疗下呼吸道感染革兰阳性球菌的疗效和安全性评价. 中华医院感染学杂志, 2009, 19(16):2172-2175.
23. 孙晓霞, 方巍, 孙运波. 万古霉素和替考拉宁治疗ICU耐甲氧西林金黄色葡萄球菌感染的评价. 齐鲁医学杂志, 2009, 24(6):533-534.
24. 董樑, 陈小东. 替考拉宁与万古霉素治疗MRSA下呼吸道感染的疗效与安全性评价. 中华医院感染学杂志, 2010, 20(5):711-713.
25. 谢续标, 叶明佶, 彭龙开, 等. 国产替考拉宁与进口万古霉素治疗肾移植术后革兰阳性球菌肺部感染的评价. 中华医院感染学杂志, 2010, 20(15):2296-2298.
26. 单联斌, 王超. 替考拉宁治疗革兰氏阳性球菌肺炎的疗效. 中国实用医刊, 2012, 38(20):115-116.
27. 童皖宁, 卓安山, 曹玉书, 等. 几种常用抗MRSA药物在老年患者肺部感染中的疗效比较. 临床军医杂志, 2015, 41(2):124-127.
28. 谭永峰, 冯星火, 王春. 替考拉宁治疗呼吸机相关性肺炎疗效与安全性评价. 中华医院感染学杂志, 2014, 24(11):2678-2682.
29. 许敬菊. 替考拉宁与万古霉素治疗耐甲氧西林金黄色葡萄球菌肺炎的疗效比较. 中国基层医药, 2014, 21(16):2416-2417.
30. 朱婉凌, 刘艳红, 于洪涛, 等. 替考拉宁治疗慢性阻塞性肺疾病患者革兰阳性菌感染的临床研究. 中华医院感染学杂志, 2014, 24(23):5820-5822.
31. 冯学仁, 陆华东, 崔恩海. 不同剂量替考拉宁治疗耐甲氧西林金黄色葡萄球菌感染呼吸机相关性肺炎的疗效研究. 中华医院感染学杂志, 2014, 24(2):349-351.
32. 刘绍霞, 李金红. 不同剂量替考拉宁治疗重症医院获得性肺炎疗效观察及安全性评价. 中华医院感染学杂志, 2012, 22(17):3841-3843.
33. 杨睿, 鲁新华, 张国俊. 不同起始负荷剂量替考拉宁治疗革兰阳性菌下呼吸道感染的疗效与安全性评价. 中华医院感染学杂志, 2015, 25(20):4673-4675.
34. 林春燕, 刘晓妍, 刘升明. 利奈唑胺对比糖肽类抗菌药物治疗MRSA相关性院内获得性肺炎的疗效和安全性的Meta分析. 中国药房, 2014, 25(20):1900-1903.
35. 石庆平, 丁峰, 刘雁, 等. 替考拉宁与万古霉素治疗革兰阳性菌感染疗效和安全性评价. 中国医院药学杂志, 2012, 32(7):535-539.
36. Gould FK, Brindle R, Chadwick PR, et al. Guidelines (2008) for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the United Kingdom. J Antimicrob Chemother, 2009, 63(5):849-861.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Teicoplanin versus Vancomycin for Lower Respiratory Tract Infection with Gram-positive Bacteria in Chinese Population: A Meta-analysis

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