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  • 1 Budapesti Corvinus Egyetem Egészség-gazdaságtani és Egészségügyi Technológiaelemzési Kutatóközpont Budapest Fővám tér 8. 1093
  • 2 Egyesített Szent István és Szent László Kórház VII. Infektológiai Osztály Budapest
  • 3 Egyesített Szent István és Szent László Kórház IV. Infektológiai Osztály Budapest
  • 4 Egyesített Szent István és Szent László Kórház Hematológiai és Őssejt-transzplantációs Osztály Budapest
  • 5 Egyesített Szent István és Szent László Kórház Infekciókontroll Osztály Budapest
  • 6 MH EK Honvédkórház Gasztroenterológiai Osztály Budapest
  • 7 MH EK Honvédkórház Kórházhigiéniai Osztály Budapest
  • 8 Szegedi Tudományegyetem, Általános Orvostudományi Kar Klinikai Mikrobiológiai Diagnosztikai Tanszék Szeged
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Bevezetés: A Clostridium difficile az antibiotikum asszociálta hasmenések leggyakoribb kórokozója, aminek kezelésére az elmúlt évtizedekben kevés új szer került kifejlesztésre, és a tudományos bizonyítékok korlátozott mértékben és nehezen összehasonlítható módon állnak rendelkezésre. Célkitűzés: A Clostridium difficile okozta fertőzés terápiájának hatásossági és biztonságossági végpontjainak elemzése a metronidazol, vancomycin és a fidaxomicin alkalmazása esetén. Módszer: A szakirodalom áttekintése és az eredmények metaanalízise. Eredmények: A metaanalízis szerint a klinikai gyógyulás végpontban nincs szignifikáns különbség a három terápia között (esélyarányok: fidaxomicin vs. vancomycin 1,19, vancomycin vs. metronidazol 1,69 és fidaxomicin vs. metronidazol 2,00). A rekurrencia és a globális gyógyulás végpontokban a fidaxomicin szignifikánsan hatásosabbnak bizonyult, mint a vancomycin és a metronidazol (esélyarányok: fidaxomicin vs. vancomycin 0,47, vancomycin vs. metronidazol 0,91 és fidaxomicin vs. metronidazol 0,43). A biztonságossági végpontokat tekintve nem volt szignifikáns különbség az antibiotikumok között. Következtetések: A klinikai gyógyulás esetében a vizsgált antibiotikumok hatásossága hasonló. A rekurrens fertőzések megakadályozásában jelenleg a fidaxomicin a leghatásosabb terápiás alternatíva. Orv. Hetil., 2013, 154, 890–899.

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