Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis
Abstract Background To compare the efficacy and safety of double-carbapenem therapy (DCT) with other antibiotics for the treatment of multidrug resistant (MDR) Gram-negative bacterial infections. Methods Cochrane Library, PubMed, Embase and Web of Science as well as Chinese databases were searched f...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05133-0 |
| _version_ | 1818241315280781312 |
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| author | Yuan-yuan Li Jin Wang Rui Wang Yun Cai |
| author_facet | Yuan-yuan Li Jin Wang Rui Wang Yun Cai |
| author_sort | Yuan-yuan Li |
| collection | DOAJ |
| description | Abstract Background To compare the efficacy and safety of double-carbapenem therapy (DCT) with other antibiotics for the treatment of multidrug resistant (MDR) Gram-negative bacterial infections. Methods Cochrane Library, PubMed, Embase and Web of Science as well as Chinese databases were searched from database establishment to February 2019. All types of studies were included if they had evaluated efficacy and safety of DCT regimens in patients with MDR Gram-negative bacterial infections. Clinical response, microbiological response, adverse events and mortality were the main outcomes. The protocol was registered with PROSPERO No. CRD42019129979. Results Three cohort or case-control studies consisting of 235 patients and 18 case series or case reports consisting of 90 patients were included. The clinical and microbiological responses were similar between DCT and other regimens in patients with carbapenem-resistant Enterobacteriaceae (CRE) infection. DCT achieved a lower mortality than comparators in patients with CRE infection (OR = 0.44, 95% CI = 0.24–0.82, P = 0.009). Ertapenem was the most reported antibiotic in DCT regimens in case series or case reports. Moreover, clinical and microbiological improvements were found in 59 (65.6%) and 63 (70%) in total 90 cases, respectively. Conclusions DCT was as effective as other antibiotics in treating MDR Gram-negative bacterial infections, with similar efficacy response and lower mortality. DCT could be an alternative therapeutic option in the treatment of MDR Gram-negative bacterial infections. High-quality randomized controlled trials were required to confirm the beneficial effects of DCT. |
| first_indexed | 2024-12-12T13:27:23Z |
| format | Article |
| id | doaj.art-67ff0503c5e04dd8bd7626ab44417ba3 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-12T13:27:23Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-67ff0503c5e04dd8bd7626ab44417ba32022-12-22T00:23:08ZengBMCBMC Infectious Diseases1471-23342020-06-0120111310.1186/s12879-020-05133-0Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysisYuan-yuan Li0Jin Wang1Rui Wang2Yun Cai3Center of Medicine Clinical Research, Department of Pharmacy, PLA General HospitalCenter of Medicine Clinical Research, Department of Pharmacy, PLA General HospitalCenter of Medicine Clinical Research, Department of Pharmacy, PLA General HospitalCenter of Medicine Clinical Research, Department of Pharmacy, PLA General HospitalAbstract Background To compare the efficacy and safety of double-carbapenem therapy (DCT) with other antibiotics for the treatment of multidrug resistant (MDR) Gram-negative bacterial infections. Methods Cochrane Library, PubMed, Embase and Web of Science as well as Chinese databases were searched from database establishment to February 2019. All types of studies were included if they had evaluated efficacy and safety of DCT regimens in patients with MDR Gram-negative bacterial infections. Clinical response, microbiological response, adverse events and mortality were the main outcomes. The protocol was registered with PROSPERO No. CRD42019129979. Results Three cohort or case-control studies consisting of 235 patients and 18 case series or case reports consisting of 90 patients were included. The clinical and microbiological responses were similar between DCT and other regimens in patients with carbapenem-resistant Enterobacteriaceae (CRE) infection. DCT achieved a lower mortality than comparators in patients with CRE infection (OR = 0.44, 95% CI = 0.24–0.82, P = 0.009). Ertapenem was the most reported antibiotic in DCT regimens in case series or case reports. Moreover, clinical and microbiological improvements were found in 59 (65.6%) and 63 (70%) in total 90 cases, respectively. Conclusions DCT was as effective as other antibiotics in treating MDR Gram-negative bacterial infections, with similar efficacy response and lower mortality. DCT could be an alternative therapeutic option in the treatment of MDR Gram-negative bacterial infections. High-quality randomized controlled trials were required to confirm the beneficial effects of DCT.http://link.springer.com/article/10.1186/s12879-020-05133-0Double-carbapenem therapyAntibioticsCarbapenem-resistant EnterobacteriaceaeMultidrug resistantMeta-analysis |
| spellingShingle | Yuan-yuan Li Jin Wang Rui Wang Yun Cai Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis BMC Infectious Diseases Double-carbapenem therapy Antibiotics Carbapenem-resistant Enterobacteriaceae Multidrug resistant Meta-analysis |
| title | Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis |
| title_full | Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis |
| title_fullStr | Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis |
| title_full_unstemmed | Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis |
| title_short | Double-carbapenem therapy in the treatment of multidrug resistant Gram-negative bacterial infections: a systematic review and meta-analysis |
| title_sort | double carbapenem therapy in the treatment of multidrug resistant gram negative bacterial infections a systematic review and meta analysis |
| topic | Double-carbapenem therapy Antibiotics Carbapenem-resistant Enterobacteriaceae Multidrug resistant Meta-analysis |
| url | http://link.springer.com/article/10.1186/s12879-020-05133-0 |
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