我来试试。有翻译得不对的地方，请指教!
Am J Med. 2007 Sep;120(9):783-90. Links
Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis.Li JZ, Winston LG, Moore DH, Bent S.
Department of Medicine, San Francisco VA Medical Center, University of California, San Francisco, CA 94143-0862, USA. jli22@partners.org
PURPOSE: There is little consensus on the most appropriate duration of antibiotic treatment for community-acquired pneumonia. The goal of this study is to systematically review randomized controlled trials comparing short-course and extended-course antibiotic regimens for community-acquired pneumonia. METHODS: We searched MEDLINE, Embase, and CENTRAL, and reviewed reference lists from 1980 through June 2006. Studies were included if they were randomized controlled trials that compared short-course (7 days or less) versus extended-course (>7 days) antibiotic monotherapy for community-acquired pneumonia in adults. The primary outcome measure was failure to achieve clinical improvement. RESULTS: We found 15 randomized controlled trials matching our inclusion and exclusion criteria comprising 2796 total subjects. Short-course regimens primarily studied the use of azithromycin (n=10), but trials examining beta-lactams (n=2), fluoroquinolones (n=2), and ketolides (n=1) were found as well. Of the extended-course regimens, 3 studies utilized the same antibiotic, whereas 9 involved an antibiotic of the same class. Overall, there was no difference in the risk of clinical failure between the short-course and extended-course regimens (0.89, 95% confidence interval [CI], 0.78-1.02). In addition, there were no differences in the risk of mortality (0.81, 95% CI, 0.46-1.43) or bacteriologic eradication (1.11, 95% CI, 0.76-1.62). In subgroup analyses, there was a trend toward favorable clinical efficacy for the short-course regimens in all antibiotic classes (range of relative risk, 0.88-0.94). CONCLUSIONS: The available studies suggest that adults with mild to moderate community-acquired pneumonia can be safely and effectively treated with an antibiotic regimen of 7 days or less. Reduction in patient exposure to antibiotics may limit the increasing rates of antimicrobial drug resistance, decrease cost, and improve patient adherence and tolerability.
短期抗生素治疗社区获得性肺炎的效果:一个Meta分析
目的：社区获得性肺炎抗生素治疗的最适宜疗程还没有统一。这项研究的目的在于系统评价社区肺炎短疗程和长疗程方法相比较的随机对照试验。方法：搜索、复习从1980年到2006年6月来自MEDILINE，EMBASE 和CENTRAL的文献，研究包括随机对照试验中比较成人社区肺炎短程（7天或少于7天）和长程（大于7天）抗生素单一疗法的效果。最初的结果测量没有获得临床改善。结果：在总共2796篇文献中发现15个随机对照试验满足我们的纳入和排除标准。短程疗法最初研究阿齐霉素的使用，但试验中也发现有β-内酰胺类药物（2例）、喹诺酮类药物（2例）和酮内酯类（1例）；长疗程方法中，3个研究用相同的抗生素，与之相反，9个研究涉及一个同类抗生素。总之，短程和长程疗法在临床治疗失败的危险方面无差异（0.89, 95%可信区间[CI]，0.78-1.02）。另外，在病死危险或细菌清除方面也没有差异（0.89, 95%可信区间[CI]，0.46-1.43）或（1.11, 95%可信区间[CI]，0.76-1.62）。在亚组分析中，发现所有抗生素种类的短程疗法趋向于满意的临床效果。结论：现有的研究提示患轻、中度社区肺炎的成人用7天或少于7天的抗生素治疗是安全和有效的。减少病人对抗生素的暴露可以限制抗菌药物耐药率的上升，降低费用，并提高病人用药的坚持和耐受性。 |
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