Comparing prolonged infusion to intermittent infusion strategies for beta-lactam antibiotics in patients with gram-negative bacterial infections: a systematic review and meta-analysis.

IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES
Chih-Chung Lin, Jheng-Yen Wu, Po-Yu Huang, Hui-Lin Sung, Yu-Chun Tung, Chih-Cheng Lai, Yu-Feng Wei, Pin-Kuei Fu
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引用次数: 0

Abstract

Introduction: Our objective is to determine whether prolonged infusion (PI) of beta-lactam antibiotics yields superior outcomes compared to intermittent infusion (II) in patients with Gram-Negative Bacterial (GNB) infections.

Methods: We systematically searched papers from PubMed, the Cochrane Library, Embase, and Clinicaltrials.gov, targeting mortality as the primary outcome and looking at the clinical cure rate, hospital and intensive care unit (ICU) stay lengths, antibiotic treatment duration, and mechanical ventilation (MV) duration as secondary outcomes.

Results: Our meta-analysis of 18 studies, including 5 randomized control trials and 13 observational studies, with a total of 3,035 patients-1,510 in the PI group and 1,525 in the II group, revealed significant findings. PI was associated with reduced mortality (RR, 0.67; 95% CI, 0.55-0.81; p = 0.001; I2 = 4.52%) and a shorter MV duration (SMD, -0.76; 95% CI, -1.37 to -0.16; p = 0.01; I2 = 87.81%) compared to II. However, no differences were found in clinical cure rates, antibiotic treatment duration, length of hospital stay, or length of ICU stay.

Conclusions: The PI approach for administering beta-lactam antibiotics in patients with suspected or confirmed GNB infections may be advantageous in reducing mortality rates and the duration of MV when compared to the II strategy.

革兰氏阴性菌感染患者长期输注和间歇性输注β-内酰胺类抗生素策略的比较:系统综述和荟萃分析。
简介:我们的目的是确定在革兰氏阴性菌(GNB)感染患者中,长期输注(PI)β-内酰胺类抗生素是否比间歇输注(II)产生更好的疗效:我们系统地检索了PubMed、Cochrane图书馆、Embase和Clinicaltrials.gov上的论文,将死亡率作为主要结果,将临床治愈率、住院和重症监护室(ICU)停留时间、抗生素治疗持续时间和机械通气(MV)持续时间作为次要结果:我们对 18 项研究进行了荟萃分析,其中包括 5 项随机对照试验和 13 项观察性研究,共涉及 3035 名患者--PI 组 1510 人,II 组 1525 人。与 II 组相比,PI 与死亡率降低(RR,0.67;95% CI,0.55-0.81;p = 0.001;I2 = 4.52%)和 MV 持续时间缩短(SMD,-0.76;95% CI,-1.37 至 -0.16;p = 0.01;I2 = 87.81%)相关。然而,在临床治愈率、抗生素治疗持续时间、住院时间或重症监护室停留时间方面没有发现差异:结论:在疑似或确诊 GNB 感染患者中使用 PI 法使用β-内酰胺类抗生素与 II 法相比,在降低死亡率和缩短 MV 持续时间方面可能更有优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
66
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
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