译文：社区获得性肺炎抗菌药物的短程疗法-Meta分析

icchina

读到一篇很好的文章，请哪位帮我翻译一下，谢谢。

Am J Med. 2007 Sep;120(9):783-90.

                               
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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.
PMID: 17765048 [PubMed - in process]

桂花香

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。

木瓜

“最初的结果测量没有获得临床改善。”我觉得这句话的翻译应该是最主要的评价指标是临床治疗失败，因为后面也提到了要比较两种方法治疗失败的危险性。

桂花香

原帖由 木瓜 于 2007-9-11 15:33 发表

                               
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“最初的结果测量没有获得临床改善。”我觉得这句话的翻译应该是最主要的评价指标是临床治疗失败，因为后面也提到了要比较两种方法治疗失败的危险性。

确实应该是这样！感谢您的指正！:P :victory:

icchina

同意这句翻译“最主要的评价指标是临床治疗失败”；

还有一句这样翻译是否更好些
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.
短程疗法主要研究阿齐霉素，但发现有验证β-内酰胺类药物（2例）、喹诺酮类药物（2例）和酮内酯类（1例）的临床试验；

桂花香

原帖由 icchina 于 2007-9-11 17:32 发表

                               
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同意这句翻译“最主要的评价指标是临床治疗失败”；

还有一句这样翻译是否更好些
Short-course regimens primarily studied the use of azithromycin (n=10), but trials examining beta-lactams (n=2), fl ...

谢谢您的指教！您翻译的就是贴切！看来不管是感染控制知识还是文字表达能力，都得加倍努力啊。

一枝梅

欢迎各位高手多来指导,强烈要求哦!!!!:handshake :handshake

楚楚

美国胸科协会和感染病协会制定的医院内获得性肺炎诊疗指南（2005年)也提到了类似的观点。

icchina

原帖由 楚楚 于 2007-9-11 19:55 发表

                               
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美国胸科协会和感染病协会制定的医院内获得性肺炎诊疗指南（2005年)也提到了类似的观点。

没错。meta分析是目前循证医学中，证据级别最高的一种类型，颇受国外学者的推崇。

右手心

非常棒啊,我自己试着翻译了下,有些语句不能理解,然后再来和楼主一对,马上就明了了,
嘿嘿,谢谢哦!请继续积极参与哦!

登山者

刚开始接触实质的翻译，自感粗糙·~~而且，很多术语翻译不到位。