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Point prevalence multicenter survey of antimicrobial consumption in Russian hospitals: results of the Global-PPS 2021 俄罗斯医院抗菌药物消费的点流行多中心调查:Global-PPS 2021的结果
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.36488/cmac.2023.2.150-158
Yu.А. Belkova, S.А. Rachina, R.S. Kozlov, V.G. Kuleshov, I.S. Vasilieva, A.A Kurkova, Е.N. Bochanova, Е.V. Elokhina, D.А. Popov, U.S. Portnyagina, О.V. Reshetko, Igor N. Sychev, V.D. Shegimova, D.V. Drogashevskaya, M.S. Chesnokova, E.V. Dovgan, S.O. Korolkov, E.M. Kurtz, A.I. Levitan, T.S. Lutsevich, R.A. Osokina, L.D. Popova, E.E. Sventitskaya, L.V. Fedina
Objective. To evaluate prescribing patterns of antimicrobials and quantify them in relation to quality indicators in Russian multi-field hospitals. Materials and Methods. Point Prevalence Survey of Antimicrobial Consumption as a part of an international Global-PPS project was conducted in 8 multi-field hospitals in different Russian cities (Krasnoyarsk, Moscow, Omsk, Saratov, Smolensk, Ulan-Ude, Yakutsk) during the period from May till December 2021. Case records of patients who received therapeutic or prophylactic systemic antimicrobial agents were analyzed. Local practices of antimicrobials’ utilization were evaluated in relation to quality indicators defined by the study protocol. Results. Common mistakes requiring a prompt intervention included low adherence to clinical guidelines, absence of stop/review dates in the medical records, extended duration of surgical prophylaxis, III generation cephalosporin’s overuse and low rate of targeted therapy. Conclusions. The results of the project can be valuable for the improvement to antimicrobial utilization approaches at the study centers as well as for monitoring of antimicrobial stewardship programs’ implementation.
目标。评估抗微生物药物的处方模式,并将其与俄罗斯多野战医院的质量指标进行量化。材料与方法。作为国际全球pps项目的一部分,于2021年5月至12月期间在俄罗斯不同城市(克拉斯诺亚尔斯克、莫斯科、鄂木斯克、萨拉托夫、斯摩棱斯克、乌兰乌德、雅库茨克)的8家多野战医院进行了抗微生物药物消费点流行调查。对接受治疗性或预防性全身性抗菌药物治疗的患者病例记录进行分析。根据研究方案定义的质量指标对抗菌素使用的地方做法进行了评估。结果。需要及时干预的常见错误包括不遵守临床指南、医疗记录中没有停止/审查日期、手术预防持续时间延长、第三代头孢菌素过度使用和靶向治疗率低。结论。该项目的结果对于研究中心的抗菌素利用方法的改进以及对抗菌素管理计划实施的监测具有重要价值。
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引用次数: 0
Antimicrobial resistance-associated mutations in chromosomal genes of ESKAPE pathogens ESKAPE病原菌染色体基因耐药相关突变
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.36488/cmac.2023.2.187-201
Yu.A. Bocharova, Tatiana A. Savinova, Igor V. Chebotar
The worldwide successful expansion of ESKAPE pathogens is largely due to their ability to rapidly acquire high antimicrobial resistance levels. The bacterial resistome includes (1) plasmid-encoded genes acquired as a result of horizontal gene transfer, and (2) chromosomal genes associated with the antimicrobial resistance development. This review represents the priority list of the ESKAPE group chromosomal genes, mutations in which are associated with antimicrobial resistance. The diversity of chromosomal genes carrying antimicrobial resistance (AMR) associated mutations confers the rapid pathogen adaptation to antimicrobials by generation of multilevel pathways to neutralize antibiotics. Analysis of the AMR mechanisms associated only with plasmid resistance genes is insufficient. A comprehensive description of AMR mechanisms should include also an analysis of chromosomal genes, mutations in which lead to increased levels of antimicrobial resistance.
ESKAPE病原体在世界范围内的成功扩展主要是由于它们能够迅速获得高抗微生物药物耐药性水平。细菌抗性组包括(1)由于水平基因转移而获得的质粒编码基因,以及(2)与抗菌素耐药性发展相关的染色体基因。这篇综述代表了ESKAPE组染色体基因的优先列表,其中突变与抗菌素耐药性相关。携带抗菌素耐药性(AMR)相关突变的染色体基因的多样性,通过产生多层途径来中和抗生素,赋予了病原体对抗菌素的快速适应。仅分析与质粒抗性基因相关的抗菌素耐药性机制是不够的。对抗菌素耐药性机制的全面描述还应包括对染色体基因、导致抗菌素耐药性水平增加的突变的分析。
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引用次数: 0
Adverse drug reactions of macrolide therapy: analysis of spontaneous reports according to the Pharmacovigilance system 大环内酯类药物治疗不良反应:根据药物警戒系统自发报告的分析
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.36488/cmac.2023.1.34-40
A. Skryabina, V. Nikiforov, M. Shakhmardanov, M. Zastrozhin, V. Skryabin, D. Sychev
Objective. To perform pharmacoepidemiological analysis of spontaneous reports of adverse drug reactions (ADRs) occurred during macrolide group antibiotics prescription and registered in the “Pharmacovigilance 2.0” subsystem of the Federal Service for Surveillance in Healthcare. Materials and Methods. A retrospective pharmacoepidemiological analysis of spontaneous reports of ADRs arising from the use of all macrolide and azalide antibiotics registered in Russia and registered in the electronic database of the “Pharmacovigilance 2.0” subsystem of the Federal Service for Surveillance in Healthcare for the period from 01.04.2019 to 30.11.2022 was performed. Results. Analysis of the number of spontaneous reports of ADRs, their structure, outcomes and severity criteria was performed. The most clinically significant ADRs were identified, the occurrence of which was reported to pharmacovigilance bodies. The results of a retrospective pharmacoepidemiological analysis showed that the development of complications of pharmacotherapy in most cases was associated with the use of azithromycin and clarithromycin. The main clinical manifestations of adverse drug reactions were skin and subcutaneous tissue disorders, gastrointestinal disorders, as well as general disorders and injection site reactions. Conclusions. It was found that the reported events generally corresponded to the general spectrum of ADRs typical for individual representatives of macrolide and azalide antibiotics.
目标。对大环内酯类抗生素处方中自发报告的药物不良反应(adr)进行药物流行病学分析,并在联邦卫生保健监测服务的“药物警戒2.0”子系统中进行登记。材料与方法。对2019年4月1日至2022年11月30日期间在俄罗斯注册并在联邦卫生监测服务局“药物警戒2.0”子系统电子数据库中注册的所有大环内酯类和氮唑类抗生素的自发报告adr进行回顾性药物流行病学分析。结果分析了adr的自发报告数量、结构、结局和严重程度标准。确定最具临床意义的不良反应,并向药物警戒机构报告其发生情况。回顾性药物流行病学分析结果显示,大多数情况下药物治疗并发症的发生与阿奇霉素和克拉霉素的使用有关。药物不良反应的主要临床表现为皮肤及皮下组织紊乱、胃肠道紊乱,以及一般紊乱和注射部位反应。结论:所报道的事件基本符合大环内酯类和杜鹃花类抗生素个别代表的典型adr的一般谱。
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引用次数: 0
Promising antimycotics for the treatment of invasive infections 有前途的抗真菌药物治疗侵袭性感染
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.36488/cmac.2023.2.165-170
E.А. Ortenberg
This paper provides a review of the largest studies (over the period of 2018 to 2023) of promising novel antimycotics and their possible role in the treatment of invasive mycoses, including infections caused by resistant Candida and Aspergillus isolates.
本文回顾了2018年至2023年期间有关新型抗真菌药物的最大规模研究,以及它们在治疗侵袭性真菌病(包括耐药念珠菌和曲霉菌分离株引起的感染)中的可能作用。
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引用次数: 0
Report of the Russian database on adverse drug reactions for COVID-19-related drugs with a focus on favipiravir 俄罗斯covid -19相关药物不良反应数据库报告,重点是法匹拉韦
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.36488/cmac.2023.1.26-33
S. Mishinova, G. Syraeva, A. Kolbin, Y. Polushin, E.V. Verbickaya
Objective. The purpose of this study is to systematize and comprehensively evaluate safety data on the drug favipiravir using the national pharmacovigilance database of the Russian Federation. Materials and Methods. The report is based on spontaneous reports in the national automated information system of pharmacovigilance of the Russian Federation for the reporting period from 01.01.2020 – 04.07.2022. To identify safety signals we used disproportionality analysis, to estimate consumption of favipiravir – indicator of the number of consumed DDDs, we additionally performed review of concomitant therapy as a risk factor for serious adverse reactions. Results. A total of 412 reports of 585 adverse reactions was included in the analytic phase. The largest number of reports referred to liver and biliary tract disorders – 166 (38%), gastrointestinal disorders – 93 (16%), changes in laboratory and instrumental data – 53 (9%), and immune system disorders – 44 (7%). A total consumption of oral favipiravir expressed in the number of maintenance daily doses for 2021 was 46,417,274.87, i.e. 30 times the consumption of remdesivir and 6 times the consumption of hydroxychloroquine. One potential statistical safety signal such as hypercreatininemia was identified. Conclusions. Development of hypercreatininemia is a potential statistical safety signal of favipiravir, which requires further validation.
目标。本研究的目的是利用俄罗斯联邦国家药物警戒数据库对药物favipiravir的安全性数据进行系统化和全面评价。材料与方法。该报告是根据俄罗斯联邦国家药物警戒自动信息系统在2020年1月1日至2022年7月4日报告期间的自发报告编写的。为了确定安全性信号,我们使用歧化分析来估计favipiravir的用量——DDDs使用量的指标,我们还对伴随治疗作为严重不良反应的危险因素进行了回顾。结果:分析阶段共纳入了412例585例不良反应报告。最多的报告涉及肝脏和胆道疾病- 166例(38%),胃肠道疾病- 93例(16%),实验室和仪器数据变化- 53例(9%),免疫系统疾病- 44例(7%)。以2021年维持日剂量数表示的口服favipiravir总用量为46,417,274.87,是remdesivir用量的30倍,是羟氯喹用量的6倍。结论:高肌酐血症的发生是favipiravir的一个潜在的统计学安全性信号,有待进一步验证。
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引用次数: 0
Problems of assessing economic effectiveness of antimicrobial agents: an experience of the Russian Federation 评估抗菌剂经济效益的问题:俄罗斯联邦的经验
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.1.23-29
Y. Gomon, A. Kolbin
Objective. To assess the actual practice of conducting clinical and economic studies of antimicrobial medicines included in the federal drug restrictive lists in the period from 2017 to the present. Materials and Methods. As part of the study, the lists of Vital and Essential Drugs in the period from 2017 to 2021 were analyzed for the identification of newly included Class J medicines «Antimicrobial drugs for systemic use» followed by a search for available clinical and economic studies. Results. Data were obtained on 8 clinical and economic studies for 6 drugs used for systemic antimicrobial therapy. The evaluation of available methodological approaches to the assessment of the economic effectiveness of antimicrobial drugs was carried out. Sensitivity analysis was used to test the stability of the results to changes in the effectiveness of strategies over time. Information about the effectiveness was based on international, more often pre-registration randomized clinical trials and their meta-analyses, without taking into account the epidemiological situation in the Russian Federation. For chronic infections, the indicator of the degree of patients’ adherence to therapy remains not taken into account. In the vast majority of studies, only direct medical costs are taken into account. Conclusions. Evaluation of the economic effectiveness of the use of antimicrobial drugs requires, on the one hand, an expansion of the set of technical tools, taking into account the specific features of this group: the problem of bacterial resistance, epidemiological features of the spread of diseases, the importance of antibacterial therapy and prevention in the introduction of other medical technologies, on the other hand, a systematic analysis of the results of studies to assess the compliance of forecasts with the real economic effects of the introduction of medical technology.
目标。评估2017年至今联邦药物限制清单所列抗菌药物的临床和经济研究的实际做法。材料与方法。作为研究的一部分,分析了2017年至2021年期间的重要和基本药物清单,以确定新纳入的J类药物“用于全身使用的抗菌药物”,然后搜索可用的临床和经济研究。对抗菌药物经济有效性评估的现有方法学方法进行了评价。敏感性分析用于测试结果对策略有效性随时间变化的稳定性。关于有效性的信息是基于国际上更经常是注册前的随机临床试验及其荟萃分析,没有考虑到俄罗斯联邦的流行病学情况。对于慢性感染,患者坚持治疗的程度这一指标仍未被考虑在内。在绝大多数研究中,只考虑了直接医疗费用。结论:评估使用抗菌药物的经济效益,一方面需要扩大一套技术工具,考虑到这一群体的具体特点:细菌耐药性问题、疾病传播的流行病学特征、抗菌治疗和预防在其他医疗技术引进中的重要性,另一方面,对研究结果进行系统分析,以评估与预测医疗技术引进的实际经济效果的符合性。
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引用次数: 0
Enigmatic Achromobacter 神秘的无色菌
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.1.4-13
I. Chebotar, Y. Bocharova
This review aims to describe the microbiological characteristics, resistant features and pathogenic potential of Achromobacter spp. Achromobacter as an opportunistic pathogen can cause severe and even fatal infections. The current knowledge about molecular basis of clinically significant traits of Achromobacter spp. was critically analyzed. The understanding of pathogenicity factors of Achromobacter spp. are largely based on predictive analysis and the role of the most factors was not confirmed by in vivo and in vitro studies. Achromobacter spp. are intrinsically resistant to many groups of antibiotics and can rapidly acquire an adaptive antibiotic resistance. Only three antibiotics (meropenem, piperacillin/tazobactam, and trimethoprim/sulfamethoxazole) have the established breakpoints for Achromobacter spp. There is an unmet need to develop available and accurate methods for species identification of Achromobacter spp.
本文综述了无色杆菌(Achromobacter spp.)的微生物学特征、耐药特征和致病性。无色杆菌是一种条件致病菌,可引起严重甚至致命的感染。本文对无色杆菌临床显著特征的分子基础的现有知识进行了批判性分析。对无色杆菌致病性因素的认识主要基于预测分析,大多数因素的作用尚未得到体内和体外研究的证实。无色杆菌对许多种类的抗生素具有内在抗性,并能迅速获得适应性抗生素耐药性。只有三种抗生素(美罗培南、哌拉西林/他唑巴坦和甲氧苄啶/磺胺甲恶唑)具有确定的无色杆菌的断点。开发可用和准确的无色杆菌种类鉴定方法的需求尚未得到满足。
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引用次数: 0
Assessment of healthcare workers’ smartphones for microbial contamination 卫生保健工作者智能手机微生物污染评估
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.1.83-88
N.A. ​Stepanov, T. Rukosueva, E. Bochanova, A. V. Borovleva, A.V. Ganzha, K.I. Eremina, V. Soboleva
Objective. To assess bacterial contamination of smartphone surfaces belonging to medical staff and medical students who provide round-the-clock medical care in Krasnoyarsk hospitals and who do not work in those institutions. Materials and Methods. Bacterial contamination of 122 smartphones owned by medical staff and medical students was studied in the following groups: doctors (n = 31), nurses (n = 29), students, who work in MIs (n = 27), and students who do not work in MIs (n = 35). The study included a survey for all participants to assess frequency of their smartphones cleaning. Results. Every fifth smartphone (26 of 122) was found to be contaminated. Staphylococcus spp. were identified on the devices of 27.6% of nurses, 13% of doctors, 14.8% of students working in MIs, and 20% of students not working in MIs. E. coli strains were not found. However, four cultures belonging to Acinetobacter spp. with three samples belonging to the A. baumannii were isolated from nurses’ smartphones. According to the results of the survey, 18% (n = 22) of the study participants never clean their smartphones, including 3.5% (n = 1) of nurses, 9.7% (n = 3) of doctors, 22.2% (n = 6) of students who work in MIs and 34.3% (n = 12) of students who do not work in MIs. In general, healthcare workers (doctors, nurses, working students) disinfect their smartphones significantly more frequently (several times a day) than students who do not work in MIs (1⁄3 of these students never do this, (p ≤ 0.05)). About 88% of the responders who regularly clean their smartphones use alcohol or alcohol wipes. Conclusions. It is necessary to strengthen control over the microbiological safety of healthcare institutions staff’s smartphones. Also, it is essential to strengthen medical students’ training on the issue of healthcare-associated infections dissemination mechanisms.
目标。评估在克拉斯诺亚尔斯克医院提供24小时医疗服务但不在这些机构工作的医务人员和医学生的智能手机表面的细菌污染情况。材料与方法。对122部医务人员和医学生拥有的智能手机进行细菌污染研究,分为医生(n = 31)、护士(n = 29)、在MIs工作的学生(n = 27)和不在MIs工作的学生(n = 35)。该研究还对所有参与者进行了一项调查,以评估他们清洁智能手机的频率。结果发现,每五分之一的智能手机(122部智能手机中的26部)被污染。27.6%的护士、13%的医生、14.8%的MIs专业学生和20%的非MIs专业学生的设备上检出了葡萄球菌。未发现大肠杆菌菌株。然而,从护士的智能手机中分离出4个属于不动杆菌的培养物和3个属于鲍曼不动杆菌的样本。调查结果显示,18% (n = 22)的研究参与者从不清洁智能手机,其中3.5% (n = 1)的护士、9.7% (n = 3)的医生、22.2% (n = 6)的MIs工作学生和34.3% (n = 12)的非MIs工作学生。一般来说,卫生保健工作者(医生、护士、工作学生)对智能手机消毒的频率(每天数次)明显高于非MIs工作的学生(1 / 3的学生从不这样做,p≤0.05)。在定期清洁智能手机的应答者中,约88%的人使用酒精或酒精湿巾。结论:有必要加强对医疗机构工作人员智能手机微生物安全的控制。此外,必须加强医学生对医疗保健相关感染传播机制问题的培训。
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引用次数: 0
Distribution of antimicrobial resistance among clinical and food Listeria monocytogenes isolated in Moscow in 2019–2021 2019-2021年莫斯科临床和食品分离单核细胞增生李斯特菌耐药性分布
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.2.156-164
S. Ermolaeva, T. Karpova, P. Andriyanov, P. A. Zhurilov, O. Voronina, N. Ryzhova, E. Aksenova, M. Kunda, E. A. Liskova, O. Gruzdeva, E. Klimova, E.A. Posukhovsky, G. Karetkina, A. Melkumyan, O. E. Orlova, E. Burmistrova, T. Pronina, I. Tartakovsky
Objective. To determine the current state-of-art of acquired resistance to antimicrobial drugs among L. monocytogenes strains associated with listeriosis in humans and food contamination in Moscow. Materials and Methods. We used 39 L. monocytogenes strains isolated in Moscow in 2019–2021 from clinical material (n = 24) and food (n = 15). Resistance to 12 antibiotics of the first and second lines of defense was studied using disk-diffusion method. The parameters recommended for L. monocytogenes were used to interpret the results; in the absence of recommendations for L. monocytogenes, the criteria for Staphylococcus aureus and/or Enterococcus spp. were used. Results. All strains were susceptible to ampicillin, benzylpenicillin, erythromycin, vancomycin, imipenem, linezolid, and the amoxicillin/clavulanic acid. Resistance was observed to gentamicin (23%) as well as to meropenem, trimethoprim/sulfamethoxazole and ciprofloxacin (5%, 74% and 28% of strains, respectively). A total of 15 strains with multiple antibiotic resistance were identified (13 and 2 isolates were resistant to three and four antibiotics, respectively). Simultaneous resistance to trimethoprim/sulfamethoxazole, ciprofloxacin and levofloxacin was observed in 9 strains, 6 strains were resistant to gentamicin and trimethoprim/sulfamethoxazole, including 3 strains – to gentamicin, trimethoprim/sulfamethoxazole, levofloxacin, and 2 strains – to gentamicin, trimethoprim/sulfamethoxazole, ciprofloxacin. Comparison of the growth inhibition zones by ampicillin and benzylpenicillin in the studied strains with historical data on the strains isolated in Russia in 1950–1980 showed a significant downward shift in the size of growth inhibition zones. Comparison of the distribution of strains with different diameters of growth inhibition zones depending on the source of isolation did not show significant differences between clinical strains and strains of food origin isolated in 2019–2021. Conclusions. A wide spread of acquired resistance was shown among L. monocytogenes strains of clinical and food origin isolated in Moscow in 2019–2021. Despite the fact that all strains were susceptible to penicillins, the distribution of growth inhibition zone diameters showed a significant shift towards decreasing sensitivity to ampicillin and benzylpenicillin in strains isolated in 2019–2021 compared with L. monocytogenes strains isolated in Russia before 1980.
目标。目的确定莫斯科与人类李斯特菌病和食品污染相关的单核细胞增生乳杆菌菌株获得性抗微生物药物耐药性的现状。材料与方法。我们使用2019-2021年在莫斯科从临床材料(n = 24)和食品(n = 15)中分离的39株单核增生乳杆菌。采用圆盘扩散法对12种第一、第二防线抗生素的耐药性进行了研究。采用单核增生乳杆菌推荐参数解释结果;结果:所有菌株均对氨苄西林、青霉素、红霉素、万古霉素、亚胺培南、利奈唑胺和阿莫西林/克拉维酸敏感。对庆大霉素耐药(23%),对美罗培南、甲氧苄啶/磺胺甲恶唑和环丙沙星耐药(分别为5%、74%和28%)。共鉴定出15株多重耐药菌株(分别对3种和4种抗生素耐药13株和2株)。9株菌株对甲氧苄啶/磺胺甲恶唑、环丙沙星、左氧氟沙星同时耐药,其中对庆大霉素、甲氧苄啶/磺胺甲恶唑、左氧氟沙星耐药6株,其中对庆大霉素、甲氧苄啶/磺胺甲恶唑、左氧氟沙星耐药3株,对庆大霉素、甲氧苄啶/磺胺甲恶唑、环丙沙星耐药2株。将所研究菌株的氨苄西林和青霉素的生长抑制带与1950-1980年俄罗斯分离的菌株的历史数据进行比较,发现生长抑制带的大小明显向下移动。对比2019 - 2021年不同分离源生长抑制带直径的菌株分布,临床菌株与食品源分离菌株无显著差异。2019-2021年在莫斯科分离的临床和食品来源的单核增生乳杆菌菌株中,获得性耐药性广泛传播。尽管所有菌株都对青霉素敏感,但与1980年以前在俄罗斯分离的单核增生乳杆菌相比,2019-2021年分离的菌株的生长抑制带直径分布明显向氨苄西林和苄西林敏感性降低转变。
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引用次数: 0
A systematic review and meta-analysis of the safety of anti-interleukin therapy in COVID-19 COVID-19抗白细胞介素治疗安全性的系统评价和荟萃分析
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.36488/cmac.2022.2.93-107
Y. Gomon, A. Kolbin, V. V. Strizheletsky, I. G. Ivanov, F. Sultanova, Y. Balykina
Objective. To evaluate safety of anti-interleukin drugs used as a pathogenetic therapy of COVID-19 as assessed by risks of infectious complications. Materials and Methods. A systematic review of publications related to safety assessment of anti-interleukin drugs recommended as pathogenetic therapy in COVID-19 patients in terms of incidence of serious adverse events and adverse events of “Infections and Invasions” class and a meta-analysis of the data were performed. Results. The meta-analysis included 16 randomized and 3 non-randomized studies. The hazard ratio of serious adverse events between the comparison groups was 0.93 95% CI 0.85; 1.01, the hazard ratio of adverse event of “Infections and Invasions” class was 0.9 95% CI 0.8; 1.02, showing no differences in the incidence of those events. Conclusions. This meta-analysis did not demonstrate statistically significant differences in the relative risks of serious adverse events and adverse events of “Infections and Invasions” class for the use of antiinterleukin drugs in COVID-19 patients.
目标。通过感染并发症的风险评估抗白细胞介素药物作为COVID-19病理治疗的安全性。材料与方法。本研究系统回顾了推荐用于COVID-19患者病理治疗的抗白细胞介素药物的严重不良事件发生率和“感染与侵袭”类不良事件的安全性评价相关文献,并对相关数据进行了荟萃分析。两组间严重不良事件的危险比为0.93,95% CI为0.85;1.01,“感染与侵袭”类不良事件的危险比为0.9,95% CI为0.8;结论:本荟萃分析显示,COVID-19患者使用抗白细胞介素药物发生严重不良事件和“感染与侵袭”类不良事件的相对风险差异无统计学意义。
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引用次数: 1
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Klinicheskaia mikrobiologiia i antimikrobnaia khimioterapiia
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