Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia.

IF 1.3 Q4 MICROBIOLOGY

Iranian Journal of Microbiology Pub Date : 2024-12-01 DOI:10.18502/ijm.v16i6.17244

Hazhir Moradi, Zahra Sadat Sajadi-Javan, Sarah Mousavi, Soodabeh Rostami, Bita Moradi Khaniabadi

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引用次数: 0

Abstract

Background and objectives: Nosocomial pneumonia caused by multidrug-resistant gram-negative bacteria presents a significant challenge for healthcare systems, as there are limited effective treatments available. This systematic review and meta-analysis aim to investigate the outcomes of colistin plus meropenem combination therapy on nosocomial pneumonia.

Materials and methods: An exhaustive search of PubMed, Scopus, Web of Science (WOS), and Embase databases was conducted, resulting in the extraction of 5 studies for qualitative assessment and meta-analysis. The study sample included 991 patients admitted with nosocomial pneumonia. The outcomes evaluated were clinical improvement, microbiological response, mortality, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE II) score, Charlson Comorbidity Index (CCI), Clinical Pulmonary Infection Score (CPIS), C-reactive protein (CRP) levels, procalcitonin (PCT) levels, and intensive care unit (ICU) duration.

Results: The results demonstrated that colistin plus meropenem combination therapy significantly improved clinical outcomes (OR = 1.37, 95% CI = 1.04-1.81, p = 0.027), reduced SOFA scores (OR = -0.28, 95% CI = -0.44 to -0.11, p = 0.001), and increased CCI scores (OR = 0.16, 95% CI = 0.02-0.29, p = 0.021) compared to other medications. However, other evaluated parameters did not show significant differences.

Conclusion: This meta-analysis indicates that colistin-meropenem combination therapy is superior to other colistin-based treatments for nosocomial pneumonia in terms of clinical improvement, SOFA score reduction, and CCI score increase. Nevertheless, other variables assessed did not exhibit remarkable differences between the treatment regimens.

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粘菌素联合美罗培南治疗院内肺炎的系统评价和荟萃分析。

背景和目的：耐多药革兰氏阴性菌引起的院内肺炎对卫生保健系统提出了重大挑战，因为可用的有效治疗方法有限。本系统综述和荟萃分析旨在探讨粘菌素联合美罗培南治疗院内肺炎的疗效。材料和方法：对PubMed、Scopus、Web of Science （WOS）、Embase等数据库进行全面检索，提取5篇研究进行定性评估和meta分析。研究样本包括991例住院的院内肺炎患者。评估的结果包括临床改善、微生物反应、死亡率、顺序器官衰竭评估（SOFA）评分、急性生理和慢性健康评估（APACHE II）评分、Charlson共病指数（CCI）、临床肺部感染评分（CPIS）、c反应蛋白（CRP）水平、降钙素原（PCT）水平和重症监护病房（ICU）持续时间。结果：结果显示，与其他药物相比，粘菌素+美罗培南联合治疗显著改善了临床结局（OR = 1.37, 95% CI = 1.04 ~ 1.81, p = 0.027），降低了SOFA评分（OR = -0.28, 95% CI = -0.44 ~ -0.11, p = 0.001），提高了CCI评分（OR = 0.16, 95% CI = 0.02 ~ 0.29, p = 0.021）。而其他评价参数无显著性差异。结论：本荟萃分析表明，粘菌素-美罗培南联合治疗在临床改善、SOFA评分降低和CCI评分提高方面优于其他以粘菌素为基础的治疗。然而，评估的其他变量并没有显示出治疗方案之间的显著差异。

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

Iranian Journal of Microbiology MICROBIOLOGY-

CiteScore

2.40

自引率

7.10%

发文量

审稿时长

12 weeks

期刊介绍： The Iranian Journal of Microbiology (IJM) is an international, multi-disciplinary, peer-reviewed journal that provides rapid publication of the most advanced scientific research in the areas of basic and applied research on bacteria and other micro-organisms, including bacteria, viruses, yeasts, fungi, microalgae, and protozoa concerning the development of tools for diagnosis and disease control, epidemiology, antimicrobial agents, clinical microbiology, immunology, Genetics, Genomics and Molecular Biology. Contributions may be in the form of original research papers, review articles, short communications, case reports, technical reports, and letters to the Editor. Research findings must be novel and the original data must be available for review by the Editors, if necessary. Studies that are preliminary, of weak originality or merely descriptive as well as negative results are not appropriate for the journal. Papers considered for publication must be unpublished work (except in an abstract form) that is not under consideration for publication anywhere else, and all co-authors should have agreed to the submission. Manuscripts should be written in English.