Intravenous Colistin Monotherapy versus Combination Therapy against Carbapenem-Resistant Gram-Negative Bacteria Infections: Meta-Analysis of Randomized Controlled Trials
Abstract
:1. Introduction
2. Methods
2.1. Study Search and Selection
2.2. Definitions and Outcome
2.3. Data Analysis
3. Results
3.1. Study Selection and Characteristics
3.2. Clinical Outcomes and Microbiological Response
3.3. Subgroup Analysis
3.4. Nephrotoxicity
4. Discussion
Author Contributions
Conflicts of Interest
Appendix A. List of Terms of the Search Strategy
- “colistin” [Mesh]
- “colistin” [All Fields]
- “polymyxins“ [All Fields]
- 1 OR 2 OR 3
- “gram-negative bacteria“ [MeSH]
- “acinetobacter baumannii“ [All Fields]
- “klebsiella pneumoniae“ [MeSH Terms]
- “klebs a pneumoniae“ [All Fields]
- “pseudomonas aeruginosa“ [MeSH Terms]
- “pseudomonas aeruginosa“ [All Fields]
- “enterobacteriaceae“ [MeSH Terms]
- 5 OR 6 OR 7 OR 8 OR9 OR 10 OR 11
- “randomized“ [All Fields]
- “randomised“ [All Fields]
- “longitudinal studies“ [MeSH Terms]
- “longitudinal studies“ [All Fields]
- “prospective“ [All Fields]
- 13 OR 14 OR 15 OR 16 OR 17
- 4 AND 12 AND 18
- colistin
- polymyxin
- 1 OR 2
- gram negative bacteria
- acinetobacter baumannii
- klebsiella pneumonia
- pseudomonas aeruginosa
- enterobacteriaceae
- 4 OR 5 OR 6 OR 7 OR 8
- randomized
- prospective
- 13 OR 14
- 3 AND 9 AND 12
- MeSH descriptor colistin explode all trees
- MeSH descriptor polymyxin explode all trees
- 1 OR 2
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Author/Publication Year | Study Year | Study Site | Bacteria | Polymicrobial | Setting | Infection Type (%) | Usage of IV Colistin Dose | No. of Polymyxin | No. of Combination with |
---|---|---|---|---|---|---|---|---|---|
Aydemir, 2013 | 2011–2012 | Turkey | Carbapenem-resistant A. baumannii | No | ICU | VAP (100) | 300 mg colistin based activity/day, t.id. (9 MIU per day) | Colistin (22) | Rifampicin (21) |
Durante-Mangoni, 2013 | 2010–2011 | Italy | Extensive-drug resistant A. baumannii | Yes | ICU | VAP (69), BSI (20), HAP (9), cIAI (2) | 2 MIU every 8 h | Colistin (105) | Rifampicin (104) |
Sirijatuphat, 2014 | 2010–2011 | Thailand | Carbapenem-resistant A. baumannii | Yes | ICU and ward | Pneumonia (76.6), BSI (5.4), UTI (5.4), IAI (6.4), SSTI (3.2), CNSI (1.0), other (2.1) | 5 mg colistin based activity/kg/day (9 MIU per day) | Colistin (47) | Fosfomycin (47) |
Paul, 2018 | 2013–2016 | Israel, Greece, Italy | Carbapenem-resistant gram-negative bacteria, including A. baumannii, Enterobacteriaceae, Pseudomonas, and others | No | ICU and ward | VAP/HAP (44.8), BSI (42.6), UTI (6.4), pVAP (6.2) | 9 MIU loading, followed by 4.5 MIU every 12 h | Colistin (198) | Meropenem (208) |
Makirs, 2018 | - | Greece | Carbapenem-resistant A. baumannii | No | ICU | VAP (100) | 3 MIU t.i.d. | Colistin (19) | Ampicillin-sulbactam (20) |
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Cheng, I.-L.; Chen, Y.-H.; Lai, C.-C.; Tang, H.-J. Intravenous Colistin Monotherapy versus Combination Therapy against Carbapenem-Resistant Gram-Negative Bacteria Infections: Meta-Analysis of Randomized Controlled Trials. J. Clin. Med. 2018, 7, 208. https://doi.org/10.3390/jcm7080208
Cheng I-L, Chen Y-H, Lai C-C, Tang H-J. Intravenous Colistin Monotherapy versus Combination Therapy against Carbapenem-Resistant Gram-Negative Bacteria Infections: Meta-Analysis of Randomized Controlled Trials. Journal of Clinical Medicine. 2018; 7(8):208. https://doi.org/10.3390/jcm7080208
Chicago/Turabian StyleCheng, I-Ling, Yu-Hung Chen, Chih-Cheng Lai, and Hung-Jen Tang. 2018. "Intravenous Colistin Monotherapy versus Combination Therapy against Carbapenem-Resistant Gram-Negative Bacteria Infections: Meta-Analysis of Randomized Controlled Trials" Journal of Clinical Medicine 7, no. 8: 208. https://doi.org/10.3390/jcm7080208