雾化吸入多黏菌素治疗儿童耐药菌感染有效性和安全性的meta分析OA

Objective To systematically evaluate the efficacy and safety of nebulized inhalation of polymyxin in the treat-ment of drug-resistant bacterial infections in children by meta-analysis.Methods The computer was used to search various Chinese and English databases such as PubMed,Embase,Ovid,Cochrane Library,Web of Science,CNKI,China Biomedical Literature database,Wanfang Data Knowledge Service Platform and VIP Chinese Science and Technology Journal database.The search period covered the entire period from the establishment of each database to December 31,2025.Two researchers independently screened all the retrieved literature,evaluated the quality of the included studies and extracted the data.Meta-analysis was conducted using RevMan 5.4 software.Results A total of 7 studies were included,in-volving 387 children.The results showed that the duration of mechanical ventilation in the polymyxin group was shorter than that in the non-humidified polymyxin group(MD=-4.22,95％CI[-5.96--2.47]),and the incidence of renal function im-pairment was lower in the group receiving nebulized inhalation than in the group without nebulization(RD=-0.08,95％CI[-0.15--0.01]),the incidence of bronchospasm was higher in the group receiving nebulized inhalation than in the group without nebulization(OR=4.95,95％CI[1.09-22.39]),and the differences were statistically significant(P<0.05).There were no statistically significant differences in clinical cure rate,microbial clearance rate,hospital stay,and incidence of neurotoxicity between the two groups of children(P>0.05).Conclusion Nebulized inhalation can shorten the duration of mechanical ventilation.In terms of safety,the incidence of renal function impairment is lower,but the risk of bronchospasm is relatively higher.The effectiveness and safety of nebu-lized inhalation in children with drug-resistant bacterial infections still require more high-quality studies to further confirm.