Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysis
Abstract. Background. Clarithromycin exerts an immunomodulatory role in several human diseases. However, whether this effect improves the prognosis in patients with sepsis remains controversial, and higher levels of clinical evidence are urgently needed. To the best of our knowledge, no meta-analysi...
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| Language: | English |
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Wolters Kluwer Health/LWW
2024-06-01
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| Series: | Emergency and Critical Care Medicine |
| Online Access: | http://journals.lww.com/10.1097/EC9.0000000000000106 |
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| author | Pengyue Zhao Renqi Yao Jiaqi Yang Wei Wen Yongming Yao Xiaohui Du |
| author_facet | Pengyue Zhao Renqi Yao Jiaqi Yang Wei Wen Yongming Yao Xiaohui Du |
| author_sort | Pengyue Zhao |
| collection | DOAJ |
| description | Abstract. Background. Clarithromycin exerts an immunomodulatory role in several human diseases. However, whether this effect improves the prognosis in patients with sepsis remains controversial, and higher levels of clinical evidence are urgently needed. To the best of our knowledge, no meta-analysis to date has reported the clinical efficacy and safety of clarithromycin in sepsis.
Methods. A comprehensive literature search of PubMed, EMBASE, and the Cochrane Library was conducted up to December 31, 2022. Only randomized controlled trials comparing the clinical efficacy and safety of clarithromycin with controls among patients with sepsis or septic shock were included. Data were pooled by applying a fixed-effects model and a relative risk (RR) estimate with 95% confidence intervals (CIs) using Review Manager (version 5.3; Cochrane Collaboration, Copenhagen, Denmark).
Results. Three randomized controlled trials involving a total of 910 patients were included. The pooled results confirmed that clarithromycin had no beneficial effect on progression to multiple organ dysfunction syndrome (RR: 1.51; 95% CI: 1.02–2.25; P = 0.04; I2 = 0%), 28-day mortality (RR: 1.09; 95% CI: 0.87–1.36; P = 0.46; I2 = 0%), and 90-day mortality (RR: 0.86; 95% CI: 0.71–1.03; P = 0.10; I2 = 81%) in patients with sepsis or septic shock. Moreover, there was no difference in other serious adverse events between patients who received clarithromycin and those in the control group (RR: 1.02; 95% CI: 0.87–1.19; P = 0.83; I2 = 18%).
Conclusion. Our meta-analysis did not reveal an improvement to short-term outcomes in patients with sepsis treated with clarithromycin. However, administration of clarithromycin did not increase the risk of adverse events. |
| format | Article |
| id | doaj-art-ce8df68f10c046d3a451389dd0ce6971 |
| institution | OA Journals |
| issn | 2097-0617 2693-860X |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Emergency and Critical Care Medicine |
| spelling | doaj-art-ce8df68f10c046d3a451389dd0ce69712025-08-20T01:54:16ZengWolters Kluwer Health/LWWEmergency and Critical Care Medicine2097-06172693-860X2024-06-0142909610.1097/EC9.0000000000000106202406000-00007Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysisPengyue Zhao0Renqi Yao1Jiaqi Yang2Wei Wen3Yongming Yao4Xiaohui Du5a Department of General Surgery, First Medical Center of the Chinese PLA General Hospital, Beijing, Chinaa Department of General Surgery, First Medical Center of the Chinese PLA General Hospital, Beijing, Chinaa Department of General Surgery, First Medical Center of the Chinese PLA General Hospital, Beijing, Chinad Department of General Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China.b Translational Medicine Research Center, Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General Hospital, Beijing, Chinaa Department of General Surgery, First Medical Center of the Chinese PLA General Hospital, Beijing, ChinaAbstract. Background. Clarithromycin exerts an immunomodulatory role in several human diseases. However, whether this effect improves the prognosis in patients with sepsis remains controversial, and higher levels of clinical evidence are urgently needed. To the best of our knowledge, no meta-analysis to date has reported the clinical efficacy and safety of clarithromycin in sepsis. Methods. A comprehensive literature search of PubMed, EMBASE, and the Cochrane Library was conducted up to December 31, 2022. Only randomized controlled trials comparing the clinical efficacy and safety of clarithromycin with controls among patients with sepsis or septic shock were included. Data were pooled by applying a fixed-effects model and a relative risk (RR) estimate with 95% confidence intervals (CIs) using Review Manager (version 5.3; Cochrane Collaboration, Copenhagen, Denmark). Results. Three randomized controlled trials involving a total of 910 patients were included. The pooled results confirmed that clarithromycin had no beneficial effect on progression to multiple organ dysfunction syndrome (RR: 1.51; 95% CI: 1.02–2.25; P = 0.04; I2 = 0%), 28-day mortality (RR: 1.09; 95% CI: 0.87–1.36; P = 0.46; I2 = 0%), and 90-day mortality (RR: 0.86; 95% CI: 0.71–1.03; P = 0.10; I2 = 81%) in patients with sepsis or septic shock. Moreover, there was no difference in other serious adverse events between patients who received clarithromycin and those in the control group (RR: 1.02; 95% CI: 0.87–1.19; P = 0.83; I2 = 18%). Conclusion. Our meta-analysis did not reveal an improvement to short-term outcomes in patients with sepsis treated with clarithromycin. However, administration of clarithromycin did not increase the risk of adverse events.http://journals.lww.com/10.1097/EC9.0000000000000106 |
| spellingShingle | Pengyue Zhao Renqi Yao Jiaqi Yang Wei Wen Yongming Yao Xiaohui Du Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysis Emergency and Critical Care Medicine |
| title | Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysis |
| title_full | Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysis |
| title_short | Efficacy and safety of clarithromycin for patients with sepsis or septic shock: a systematic review and meta-analysis |
| title_sort | efficacy and safety of clarithromycin for patients with sepsis or septic shock a systematic review and meta analysis |
| url | http://journals.lww.com/10.1097/EC9.0000000000000106 |
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