| Objective：With the wide use of broad spectrum antibiotics,immunosuppressant, cytotoxic drugs and The rising incidence rate ofMalignant hematologic disease,tumour,immunodeficiency disease, theincidence rate of invasive fungal infection is also increased. Becauseof poor effect and adverse reactions of traditional antifungal agents,themortality rate is rising year by year. How to improve the curative effect,reduce adverse reactions remains an important issue in antifungal therapyField. At present，a plenty of studies about caspofungin have beenreposed．The aim of this meta analysis Was to assess the efficacy andadverse reactions of caspofungin for treatment of invasive fungalinfections in adolescents and adults Compared to (liposomal) amphotericinB. Provide evidence for clinical decision.Method：I searched CNKI，VIP，SinoMed，FEBM(ACP Journal Club、CochraneLibrary、POEMS)、PUBMED、Medline、Embase for randomized controlled trialspublished that compared CAS with AmB and LAmB on treatment of invasivefungal infections in adolescents and adults．The computer search wassupplemented with hand searches of reference lists for available primarystudies．Languages must be English or Chinese.the Cut-off time of publishis January2013.Results:7studies which included1969patients met the search criteriawere assessed. CAS group had significant advantages in effectiverate(RR=1.11，95％C1(1.01,1.22)， P=0.023)、 Pathogen eradication rate(RR=1.20，95％C1(1.05,1.37)， P=0.007)、 clinical adverseevents(RR=0.58，95％C1(0.43,0.79)，P＜0.001)、laboratory adverse events(RR=0.64，95％C1(0.56,0.74)，P＜0.001)、therapy discontinued because ofSerious adverse reactions(RR=0.25,95%C1(0.10,0.67),P=0.005) overcontrolled group.Conclusion: CAS significantly improved effect and Pathogeneradication,decrease therapy discontinued because of Serious adversereactions、clinical and laboratory adverse evens in the available RCTs.Itcan be considered as an alternative antifungal agent for the treatmentof invasive fungal infections in adolescents and adults. |
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