Efficacy And Safety Of Several Antibacterial Agents In The Treatment Of Skin And Soft Tissue Infections:Network Meta-Analysis

Objective:The objective was to conduct a systematic review and Network meta-analysis(NMA)of existing treatments for SSSI focusing on the recently approved agent from a new class of antibiotics,the cyclic lipopeptides Daptomycin.Methods:This network meta-analysis is used to determine direct and indirect evidence of relevant trials.We search for Pubmed,Embase,The Cochrane Library,The Clinical Trials.gov Website,and China National Knowledge Infrastructure(CNKI),WANFAG Database(WANFANG),and VIP Database(VIP)according to a pre-defined search strategy.Establish strict literature inclusion and exclusion criteria and evaluate the quality of the included studies in Revman.The Bayesian Network meta-analysis was performed using R software through gemtc package.The clinical success rate,microbial success rate,and safety of several antimicrobial drugs were assessed using relative risk ratio(RR)and 95% confidence interval(95% CI).Results:In this study,the Bayesian Network meta-analysis was performed using R software through gemtc package.The model selects the random effect model.The parameter was n.adapt=5000,n.iter=50000.All the outcome indicators are satisfactory under this condition.In the case of skin soft tissue infection,Daptomycin compared to several antibacterial drugs,its efficacy and safety were not statistically different.The results of the ranking showed that the clincal success rate,microbial success rate,and success rate of treatment of MRSA ranked first in the first place are Telavancin,Daptomycin,Daptomycin.The lowest incidence of severe adverse reactions was Telavancin.Conclusions:In the case of skin and soft tissue infections,Daptomycin compared to several antibacterial drugs,its efficacy and safety were not statistically different.In the microbial outcome,Daptomycin has a slight advantage;in terms of safety,the incidence of severe adverse reactions of Daptomycin is relatively small compared with Vancomycin,Linezolid,Tigecycline.However,given the limitations and heterogeneity of this meta-analysis,our conclusions need to be interpreted cautiously.The future requires larger prospective studies and more rigorous research designs to test these conclusions.