التفاصيل البيبلوغرافية
| العنوان: |
Win Ratio Analyses of Piperacillin-Tazobactam Versus Meropenem for Ceftriaxone-Nonsusceptible Escherichia coli or Klebsiella pneumoniae Bloodstream Infections: Post Hoc Insights From the MERINO Trial. |
| المؤلفون: |
Hardy, Melissa, Harris, Patrick N A, Paterson, David L, Chatfield, Mark D, Mo, Yin, Investigators, for the MERINO Trial |
| المصدر: |
Clinical Infectious Diseases; 6/15/2024, Vol. 78 Issue 6, p1482-1489, 8p |
| مصطلحات موضوعية: |
ANTIBIOTICS, COMBINATION drug therapy, DATA analysis, DRUG resistance in microorganisms, TREATMENT effectiveness, RANDOMIZED controlled trials, ESCHERICHIA coli, KLEBSIELLA infections, ESCHERICHIA coli diseases, STATISTICS, COMPARATIVE studies, CONFIDENCE intervals, PENICILLIN, MEROPENEM, CEFTRIAXONE, THERAPEUTICS, PHARMACODYNAMICS, EVALUATION |
| مستخلص: |
Background Clinical trials of treatments for serious infections commonly use the primary endpoint of all-cause mortality. However, many trial participants survive their infection and this endpoint may not truly reflect important benefits and risks of therapy. The win ratio uses a hierarchical composite endpoint that can incorporate and prioritize outcome measures by relative clinical importance. Methods The win ratio methodology was applied post hoc to outcomes observed in the MERINO trial, which compared piperacillin-tazobactam with meropenem. We quantified the win ratio with a primary hierarchical composite endpoint, including all-cause mortality, microbiological relapse, and secondary infection. A win ratio of 1 would correspond to no difference between the 2 antibiotics, while a ratio <1 favors meropenem. Further analyses were performed to calculate the win odds and to introduce a continuous outcome variable in order to reduce ties. Results With the hierarchy of all-cause mortality, microbiological relapse, and secondary infection, the win ratio estimate was 0.40 (95% confidence interval [CI],.22–.71]; P =.002), favoring meropenem over piperacillin-tazobactam. However, 73.4% of the pairs were tied due to the small proportion of events. The win odds, a modification of the win ratio accounting for ties, was 0.79 (95% CI,.68–.92). The addition of length of stay to the primary composite greatly minimized the number of ties (4.6%) with a win ratio estimate of 0.77 (95% CI,.60–.99; P =.04). Conclusions The application of the win ratio methodology to the MERINO trial data illustrates its utility and feasibility for use in antimicrobial trials. [ABSTRACT FROM AUTHOR] |
|
Copyright of Clinical Infectious Diseases is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder