Polymyxin Monotherapy vs. Combination Therapy for the Treatment of Multidrug-resistant Infections: A Systematic Review and Meta-analysis.
Carbapenems
Colistin
Combination therapy
Gram-negative bacilli infections
Monotherapy
Multidrug resistant (MDR)
Polymyxin B
Journal
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
ISSN: 0972-5229
Titre abrégé: Indian J Crit Care Med
Pays: India
ID NLM: 101208863
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
entrez:
12
3
2021
pubmed:
13
3
2021
medline:
13
3
2021
Statut:
ppublish
Résumé
The objective of this review was to compare the effectiveness of Colistin monotherapy and combination therapy for the treatment of multidrug-resistant gram-negative bacterial infections. PubMed, Cochrane Library. In this systematic review, we included all retrospective and prospective studies and randomized controlled trials (RCTs) that compared intravenous polymyxin monotherapy and combination therapy with any other antibiotic for treating multidrug-resistant infections. Studies using inhaled polymyxins with 5 or less than 5 patients were excluded. The primary outcome was 30-day all-cause mortality and if not reported at day 30 we extracted and documented the closest time point. Both crude outcome rates and adjusted effect estimates were extracted for mortality. Search string used was "(Colistin OR polymyxin) AND ( The meta-analysis of polymyxin monotherapy vs. combination therapy in multidrug-resistant infections yielded an odds ratio (OR) of 0.81 (95% confidence interval [CI]: 0.65-1.01) with minimal heterogeneity ( Although statistically insignificant, it would be prudent to use polymyxin combination therapy to treat multidrug-resistant gram-negative bacilli (GNB) infection over monotherapy with preference to use carbapenem as the adjunct alongside polymyxins. Samal S, Mishra SB, Patra SK, Rath A, Dash A, Nayak B, et al. Polymyxin Monotherapy vs. Combination Therapy for the Treatment of Multidrug-resistant Infections: A Systematic Review and Meta-analysis. Indian J Crit Care Med 2021;25(2):199-206.
Identifiants
pubmed: 33707900
doi: 10.5005/jp-journals-10071-23720
pmc: PMC7922466
doi:
Types de publication
Journal Article
Langues
eng
Pagination
199-206Informations de copyright
Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.
Déclaration de conflit d'intérêts
Source of support: Nil Conflict of interest: None
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