Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections.
OBJECTIVE: To compare the effectiveness of meropenem with imipenem plus cilastatin in the treatment of severe infections. DATA SOURCES: CENTRAL, EMBASE and MEDLINE were searched for abstracts and papers. All searching was completed in March 2004. No restriction was placed on language. STUDY SELECTI...
| Main Authors: | , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2005
|
| _version_ | 1826282848089276416 |
|---|---|
| author | Edwards, S Emmas, C Campbell, H |
| author_facet | Edwards, S Emmas, C Campbell, H |
| author_sort | Edwards, S |
| collection | OXFORD |
| description | OBJECTIVE: To compare the effectiveness of meropenem with imipenem plus cilastatin in the treatment of severe infections. DATA SOURCES: CENTRAL, EMBASE and MEDLINE were searched for abstracts and papers. All searching was completed in March 2004. No restriction was placed on language. STUDY SELECTION: Randomized controlled trials of adult patients with severe infections treated with meropenem or imipenem plus cilastatin at an equal dose, on a gram-for-gram basis, and with the same dosing regimen. DATA EXTRACTION: Two reviewers independently assessed papers against the inclusion/exclusion criteria and for methodological quality with differences in opinion adjudicated by a third party. Data were extracted on clinical response, bacteriologic response, mortality and adverse events. DATA SYNTHESIS: A total of 27 trials met the inclusion criteria. Meta-analyses were carried out using a Fixed Effects model. Results demonstrated that when compared to imipenem plus cilastatin, meropenem is associated with a significantly greater clinical response (Relative Risk 1.04; 95% Confidence Interval: 1.01-1.06), a significantly greater bacteriologic response (RR 1.05; 95% CI: 1.01-1.08), a non-significant reduction in mortality (RR 0.98; 95% CI: 0.71-1.35), and a significantly lower adverse event rate (RR 0.87; 95% CI: 0.77-0.97). CONCLUSIONS: This systematic review demonstrates that meropenem compared to imipenem plus cilastatin has a significantly greater clinical and bacteriologic response with a significant reduction in adverse events. There was no evidence of heterogeneity or publication bias and the analyses were robust to changes in the inclusion/exclusion criteria and use of a Random Effects model. |
| first_indexed | 2024-03-07T00:50:01Z |
| format | Journal article |
| id | oxford-uuid:860c1e7f-f12b-4c2c-b2cc-7a66d4fe1a2d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:50:01Z |
| publishDate | 2005 |
| record_format | dspace |
| spelling | oxford-uuid:860c1e7f-f12b-4c2c-b2cc-7a66d4fe1a2d2022-03-26T22:01:36ZSystematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:860c1e7f-f12b-4c2c-b2cc-7a66d4fe1a2dEnglishSymplectic Elements at Oxford2005Edwards, SEmmas, CCampbell, H OBJECTIVE: To compare the effectiveness of meropenem with imipenem plus cilastatin in the treatment of severe infections. DATA SOURCES: CENTRAL, EMBASE and MEDLINE were searched for abstracts and papers. All searching was completed in March 2004. No restriction was placed on language. STUDY SELECTION: Randomized controlled trials of adult patients with severe infections treated with meropenem or imipenem plus cilastatin at an equal dose, on a gram-for-gram basis, and with the same dosing regimen. DATA EXTRACTION: Two reviewers independently assessed papers against the inclusion/exclusion criteria and for methodological quality with differences in opinion adjudicated by a third party. Data were extracted on clinical response, bacteriologic response, mortality and adverse events. DATA SYNTHESIS: A total of 27 trials met the inclusion criteria. Meta-analyses were carried out using a Fixed Effects model. Results demonstrated that when compared to imipenem plus cilastatin, meropenem is associated with a significantly greater clinical response (Relative Risk 1.04; 95% Confidence Interval: 1.01-1.06), a significantly greater bacteriologic response (RR 1.05; 95% CI: 1.01-1.08), a non-significant reduction in mortality (RR 0.98; 95% CI: 0.71-1.35), and a significantly lower adverse event rate (RR 0.87; 95% CI: 0.77-0.97). CONCLUSIONS: This systematic review demonstrates that meropenem compared to imipenem plus cilastatin has a significantly greater clinical and bacteriologic response with a significant reduction in adverse events. There was no evidence of heterogeneity or publication bias and the analyses were robust to changes in the inclusion/exclusion criteria and use of a Random Effects model. |
| spellingShingle | Edwards, S Emmas, C Campbell, H Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections. |
| title | Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections. |
| title_full | Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections. |
| title_fullStr | Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections. |
| title_full_unstemmed | Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections. |
| title_short | Systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections. |
| title_sort | systematic review comparing meropenem with imipenem plus cilastatin in the treatment of severe infections |
| work_keys_str_mv | AT edwardss systematicreviewcomparingmeropenemwithimipenempluscilastatininthetreatmentofsevereinfections AT emmasc systematicreviewcomparingmeropenemwithimipenempluscilastatininthetreatmentofsevereinfections AT campbellh systematicreviewcomparingmeropenemwithimipenempluscilastatininthetreatmentofsevereinfections |