Intrathecal injection of amphotericin B in the pharmacological therapy of cryptococcal meningitis, a meta-analysis
ZHANG Xin, TU Bo, FAN Rong, NIE Wei-min, ZHAO Min
2012, 7(3):
136-141.
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Objective To assess the effectiveness and safety of intrathecal injection of amphotericin B in the therapy of cryptococcal meningitis.Methods The databases such as the Cochrane Central Register of Controlled Trials (Issue 1, 2012), Pubmed, Ovid, Springer, FMJS, CBMdisc,CMCC,CNKI,WanFang DATA,VIP Information and the CMA DATA were electronically searched (from establishment to February,2012).And the reference of the included articles were also manually searched. Controlled trials in which amphotericin B were intrathecal injected to treat patients with cryptococcal meningitis were collected. Then the retrieved studies were screened according to predefined inclusion and exclusion criteria, the quality of the included studies were evaluated, and meta-analyses were performed by RevMan 5.1.6 software.Results Eighty-nine articles were found,6 controlled trials involving 175 patients were finally included. The results of meta-analysis showed that compared with control,intrathecal inject amphotericin B could significantly improve the effective rate[OR=4.59,95%CI(2.19,9.64),P＜0.000 1],and shorten the duration of meningeal irritation sign at 8.56 d (95% CI -11.74~-5.38,P＜0.000 01),but brought about more adverse events.Conclusion Currently available evidence show that intrathecal injection of amphotericin B can improve therapeutic effect of cryptococcal meningitis,but its clinical application is limited by more adverse events. However, due to lack of quality in the included studies, more studies of better quality should be performed.
