دورية أكاديمية
Clinical efficacy and safety of prolonged versus intermittent administration of antipseudomonal beta-lactam antibiotics in adults with severe acute infections: A meta-analysis of randomized controlled trials.
| العنوان: | Clinical efficacy and safety of prolonged versus intermittent administration of antipseudomonal beta-lactam antibiotics in adults with severe acute infections: A meta-analysis of randomized controlled trials. |
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| المؤلفون: | Kıran P; Department of Infectious Diseases and Clinical Microbiology, Epidemiology Subsection, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey. Electronic address: pinar.kiran@deu.edu.tr., Nadir Y; Department of Infectious Diseases and Clinical Microbiology, Tepecik Training and Research Hospital, Izmir, Turkey., Gencer S; Department of Infectious Diseases and Clinical Microbiology, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey. |
| المصدر: | Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy [J Infect Chemother] 2023 Sep; Vol. 29 (9), pp. 855-862. Date of Electronic Publication: 2023 May 09. |
| نوع المنشور: | Journal Article; Meta-Analysis |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: Netherlands NLM ID: 9608375 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1437-7780 (Electronic) Linking ISSN: 1341321X NLM ISO Abbreviation: J Infect Chemother Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Amsterdam : Elsevier Original Publication: Tokyo : New York : Published for the Society by Churchill Livingstone, c1995- |
| مواضيع طبية MeSH: | beta-Lactams*/adverse effects , Monobactams*, Adult ; Humans ; Anti-Bacterial Agents/adverse effects ; Randomized Controlled Trials as Topic ; Treatment Outcome |
| مستخلص: | Introduction: In order to compare the clinical efficacy and safety of prolonged versus intermittent antipseudomonal beta-lactam antibiotic infusion for the treatment of severe acute infections in adult patients, a meta-analysis of randomized controlled trials (RCTs) was performed. Methods: We systematically searched MEDLINE and Cochrane Library databases until December 2022. The outcomes were all-cause mortality, clinical success, microbiological eradication and adverse events. The pooled risk ratios (RR) were estimated by the fixed or random effect methods according to heterogeneity statistics. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the certainty of evidence for each outcome. Results: Twenty eligible RCTs with 2081 participants were included in the meta-analysis. The risk of all-cause mortality was significantly lower in the prolonged infusion group than in the intermittent infusion group (RR 0.77, 95% confidence interval [CI] 0.63-0.95, p = 0.01, I 2 = 0%; moderate certainty). Treatment with prolonged infusion showed significant benefit in clinical success (RR 1.09, 95% CI 1.02-1.17, p = 0.008, I 2 = 19%; moderate certainty). There were no significant differences in microbiological eradication (RR 1.12, 95% CI 0.99-1.28, p = 0.07, I 2 = 49%; low certainty), any adverse events (RR 0.96, 95% CI 0.86-1.08, p = 0.50, I 2 = 27%; moderate certainty) and serious adverse events (RR 0.99, 95%CI 0.70-1.39 p = 0.95, I 2 = 0%; low certainty). Conclusions: Prolonged antipseudomonal beta-lactam infusion probably decreases all-cause mortality. Additionally, it probably increases clinical success in adults with severe acute infections. This infusion strategy may result in little to no difference in microbiological eradication and is probably not associated with a rise in any adverse events.The evidence suggests that prolonged infusion may not increase serious adverse events. (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Beta-lactams; Clinical efficacy; Infection; Intravenous administration; Meta-analysis; Systematic review |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) 0 (beta-Lactams) 0 (Monobactams) |
| تواريخ الأحداث: | Date Created: 20230511 Date Completed: 20230802 Latest Revision: 20230802 |
| رمز التحديث: | 20230802 |
| DOI: | 10.1016/j.jiac.2023.05.008 |
| PMID: | 37169223 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1437-7780 |
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| DOI: | 10.1016/j.jiac.2023.05.008 |