796 KB28 KB200420252004Ščuka, Leonštevilka:3/4letnik:41str. 121-127ISSN:1580-4003COBISSID:1752177URN:URN:NBN:SI:doc-FJ0NZKC8enVeterinarska fakultetaSlovenian veterinary researchbakterijske okužbeenrofloksancinprašičizdravljenjeA meta-analysis and systematic review of the efficacy of enrofloxacin - infections with the bacterium Escherichia coli in pigs|A meta-analysis is a method of surveying and combining the results of several independent clinical trials.Besides quantitative integration, a meta-analysis vastly improves the potential for uncovering and studying any differences in available scientific material and provides a basis for plausible explanations of them. It can also lead to new discoveries and allows the aggregation of knowledge in the field of interest. This analytical method is of particular importance when assessing the efficacy of a therapy when the sample sizes of individual studies are too small to cover all aspects of a particular subject or provide a quantitative evaluation of the treatmentćs effect as well as testa null hypothesis. Prior to metaanalysis, the traditional method was a narrative discourse on previous findings, which, however, could be misleading and subjective. Systematic reviews are concise summaries of the best availableevidence that address sharply defined questionsč they seek to assemble and examine all the high quality evidence on any given subject.Enrofloxacin is a fluoroquinolone chemotherapeutic that was developed exclusively for use in veterinary medicine. Shortly after administration, low concentrations have a bactericidal effect against most Gram-negative and Gram-positive bacteria and will also act against mycoplasmata. Twenty-four studies were included in this survey, of which seven were included in a meta-analysis while others were used to build a susceptibility profile of bacteria to enrofloxacin. Eight studies dealt with economic aspects of using enrofloxacin in pig rearing. The total number of animals included in the meta-analysis was 1,296, of which 655 were from the enrofloxacin-treated test groups of the different studies and 641 from their control or alternative treatment groups. In total, there were 19,235 strains of E. coli examined for their susceptibility to enrofloxacin. The results of the meta-analysis are presented graphically. The odds ratio (OR) was used as a measure of the effectsize and the homogeneity andžor heterogeneity values (Q) were calculatedfor the graphs. Additionally, a funnel plot was used to check the dispersion of the studies included in the meta-analysis. The graphs and the calculations (P = 0.43) show that the studies were homogeneous.We also combined the in vitro susceptibility of individual microbes to enrofloxacin and evaluated their MIC values. Each study supported the enrofloxacin treatmentč although there were three results that were statistically significant (P < 0.05), the overall result clearly indicates the high efficacyof enrofloxacin (P < 0.01) in reducing mortality caused by E. coli infections. Of the 19,235 strains surveyed, there were only 3.4 % that were resistant and the MIC values ranged between 0.015 and 0.25 Žgžml. The studies that dealt with the economic aspects of using enrofloxacin to combat E. coli infections, showed that it also has important additional benefits in pig rearing, especially in regards to daily weight gain and feed conversion.Moreover, enrofloxacin reduced the level of haemolytic E. coli excretions and sick animals recovered faster than those in the control or alternative treatment groups did. Our results have confirmed the high efficacyof enrofloxacin usage in E. coli infections, which makes it economically and professionally justifiable for treating coli infections in pigsMetaanaliza je metoda pregledovanja in kombiniranja rezultatov vee neodvisnih klinienih studij. Poleg kvantitativne integracije predstavlja tudi pomembno izboljsavo pri odkrivanju in preueevanju razlik v razpolozljivi znanstveni materiji in doseganju ali vsaj nudenju najverodostojnejsih razlag ter celo priodkrivanju novih spoznanj. Prispeva tudi h kopieenju znanja na doloeenem interesnem podroeju. Ta analitska metoda je se posebej pomembna pri ocenjevanju terapevtske ueinkovitosti v primerih, ko posamezne studije ne zagotavljajo pregleda nad celotno obravnavano problematiko, po navadi imajo premajhne vzorce in zato ne morejo dati kvantitativne ocene ueinka zdravljenja, in tudi ne preizkusiti nieelne hipoteze. Pred obdobjem metaanalize so pripovedno primerjali rezultate studij, kar pa je bilo lahko zavajajoee in subjektivno. Sistematieni prikazi so zgoseeni povzetki najboljsih dostopnih dokazov, ki se nanasajo na jasno doloeena vprasanjač njihov namen je zbrati in preveriti vse visoko kakovostne dokaze o doloeenem specifienem vprasanju. Enrofloksacin je kemoterapevtik iz skupine fluorokinolonov, ki je bil razvit izkljueno za uporabo v veterinarski medicini. V zelo majhnih koncentracijah in hitro po dajanju deluje baktericidno na veeino po Gramu negativnih in po Gramu pozitivnih bakterij, ueinkuje pa tudi mikoplazmocidno. V prikaz je bilo vkljueenih 24 studij, sedemod njih je bilo vkljueenih v samo metaanalizo, v drugih pa so opazovali profil obeutljivosti bakterij za enrofloksacin. V osmih studijah so obravnavali ekonomske parametre prasieereje ob uporabi enrofloksacina. Skupno stevilo zivali iz razlienih studij, vkljueenih v metaanalizo, je bilo 1296, odteh jih je bilo 655 razvrseenih v testne skupine, ki so prejemale enrofloksacin, ter 641 v kontrolne skupine, ki so prejemale primerjalno terapijo. Vse studije so vkljueevale skupno 19235 sevov E. coli, ki so jih preizkusali glede obeutljivosti za enrofloksacin. Rezultati metaanaliz so prikazani grafieno. Kot velikost ueinka smo izbrali razmerje obetov (odds ratio), izraeunavali pa smo tudi vrednosti za homogenost oz. heterogenost (Q) studij. Z lijakastim grafienim prikazom smo dodatno preverjali razprsitev studij v grafu. Iz grafov in izraeunov (P = 0.43) je razvidna homogenost vseh vkljueenih studij. Pregledali smo tudi in vitro obeutljivost posameznih mikrobov za enrofloksacin in ocenjevali vrednosti MIK. Vse studije so govorilev prid zdravljenju z enrofloksacinomč le pri treh izmed njih so bili rezultati statistieno pomembni (P < 0.05), skupni rezultat pa kaze na visoko ueinkovitost enrofloksacina (P < 0.01) pri zmanjsevanju smrtnosti zaradi okuzbz E. coli. Skupni delez odpornih sevov ni presegal 3,4 % vseh v prikazu zajetih sevov in vrednost MIK se je gibala med 0,015 in 0,25 Žgžml. Studije, vkaterih so raziskovali ekonomsko pomembne parametre rabe enrofloksacina pri okuzbah z E. coli, so pokazale pomemben ugoden ueinek enrofloksacina v prasieereji, se posebej na dnevno pridobivanje teze prasieev in izkoristek hrane. Enrofloksacin zmanjsa tudi izloeanje hemolitiene E. coli in bolne zivali si opomorejo hitreje kot tiste v kontrolni skupini, ki so vkljueene v primerjalno zdravljenje. Nasi rezultati potrjujejo, da je raba enrofloksacina pri zdravljenju okuzb z E. coli zelo ueinkovita, ekonomsko koristna in je zatopri okuzbah s kolibakterijami pri prasieih uporaba enrofloksacin strokovno upravieenaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverza v Ljubljani, Veterinarska fakulteta