Introduction: Skin and soft structure infections (SSTIs) caused by methicillin-resistant Staphylococcus aureus (MRSA) pose serious health risks and cause significant cost burdens, and a conclusive recommendation about antibiotics has not yet been generated. Therefore, we performed this updated network meta-analysis to determine the preferred drug for the treatment of MRSA-caused SSTIs. Methods: We searched PubMed, Embase, and Cochrane Library to identify any potentially eligible randomized controlled trials (RCTs) investigating the comparative efficacy and safety of any two of vancomycin, linezolid, tedizolid, and daptomycin in MRSA-caused SSTIs. All statistical analyses were conducted with RevMan, ADDIS, and STATA software. Results: Twenty eligible RCTs involving 7804 patients were included for the final analysis. Direct meta-analysis suggested that linezolid was superior to vancomycin in improving clinical (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.07-1.99; P = 0.02) and microbiological (OR, 1.89; 95% CI, 1.24-2.86; P = 0.003) success, which were all confirmed by network meta-analyses. No statistical differences were identified regarding other comparisons. Meanwhile, there were no significant differences between any two antibiotics related to safety. Moreover, ranking probabilities indicated that linezolid had the highest probability of being ranked best in terms of clinical and microbiological success.
Conclusion:Based on the limited evidence, linezolid may be a preferred antibiotic for the treatment of MRSA-caused SSTIs because it showed superiority in clinical and microbiological success without difference regarding safety.
application of topical ointments, ligation, or sclerosant injections, whereas Grades III and IV often require surgery. The most common surgical procedures used in the management of hemorrhoids are open, closed, or stapled hemorrhoidectomy (SH), and the Milligan-Morgan hemorrhoidectomy (M-M) (2). Following hemorrhoidectomy, most patients experience different
Background:The aim of the present study was to analyze the relationship between small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS) and the prognosis of treatment.Methods: A total of127 IBS patients (IBS group) were selected, and based on the results of the methane/ hydrogen breath test, they were divided into SIBO-positive group (subdivided into the antibiotic group, microecological group, and placebo group according to difference in treatment methods) and the SIBOnegative group. The incidence of SIBO and inflammatory factors in different populations were compared. Moreover, differences in the negative conversion rate of intestinal bacterial overgrowth, symptom improvement, interleukin (IL)-1β, and IL-10 levels in the antibiotic group, microecological group, and placebo group before and after treatment were compared.
Results:The IL-1β level of the IBS group was higher than that of the control group, but the level of IL-10 was lower than that of the control group (P<0.05). The level of IL-1β in the SIBO-positive group was higher than that in the SIBO-negative group, while IL-10 level was lower in the SIBO-positive group compared with the SIBO-negative group (P<0.05). Symptom scores after treatment in the antibiotic group and the microecological group were lower than those in the same groups before treatment and those in the placebo group after treatment (P<0.05). After treatment, the level of IL-1β in the antibiotic group and the microecological group decreased, whereas the level of IL-10 increased (P<0.05). Furthermore, the total clinical effective rate and negative conversion rate of the antibiotic group and the microecological group were higher than those of the placebo group (P<0.05); however, the comparison of symptom scores, inflammatory factors, and total clinical effective rate before and after treatment in the placebo group was not statistically significant (P<0.05). The symptom score after treatment in the negative conversion group was lower than that in the non-negative conversion group (P<0.05).Conclusions: SIBO plays an important role in the occurrence of IBS. Antibiotics and microecological agents can be used to correct SIBO in clinical practice to improve the symptoms of IBS patients and peripheral blood inflammatory factors.
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