Effectiveness and safety of eravacycline-based regimens for resistant Acinetobacter baumannii infections: a systematic review and meta-analysis.

IF 4.6 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2026-09-01 Epub Date: 2026-07-04 DOI:10.1080/14787210.2026.2699179

Shahd Mohammad, Eman Awwad, Ayah Hajjar, Sulaiman Alzunaydi, Ahmed Ak Al-Hammadi, Thamer A Almangour, Matteo Bassetti

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Abstract

Introduction: Acinetobacter baumannii, particularly multidrug-resistant strains, is a high-burden nosocomial pathogen with limited therapeutic options. Eravacycline is increasingly used off-label despite limited supporting clinical evidence. This meta-analysis aimed to evaluate the effectiveness and safety of eravacycline versus non-eravacycline-based regimens in adults with resistant A. baumannii infections.

Methods: MEDLINE, Embase, and Cochrane Central were searched for studies evaluating eravacycline regimens in hospitalized adults with A. baumannii infection. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Data were analyzed using R statistical software.

Results: Fifteen studies encompassing 462 patients were included. Populations consisted predominantly of older adults, with respiratory tract infections representing the most common source of infection (77.6%). Carbapenem-resistant A. baumannii accounted for 84.4% of evaluable cases. No statistically significant differences were observed between eravacycline and non-eravacycline-based regimens in all-cause mortality (RR 1.06; 95% CI 0.46-2.47), clinical cure (RR 0.90; 95% CI 0.77-1.07), or microbiological eradication (RR 0.88; 95% CI 0.56-1.37). Complementary single-arm pooled estimates among eravacycline-treated cohorts were favorable.

Conclusion: This meta-analysis strengthens the evidence base for eravacycline effectiveness in resistant A. baumannii infections and supports its consideration when preferred regimens are not feasible; adequately powered randomized trials are needed to define optimal positioning.

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以厄伐环素为基础的方案治疗耐药鲍曼不动杆菌感染的有效性和安全性：一项系统综述和荟萃分析。

鲍曼不动杆菌，特别是耐多药菌株，是一种高负担的医院病原体，治疗选择有限。尽管有限的临床证据支持，依拉瓦环素越来越多地在标签外使用。本荟萃分析旨在评估依瓦环素与非依瓦环素方案在成人耐药鲍曼不动杆菌感染中的有效性和安全性。方法：检索MEDLINE、Embase和Cochrane Central，以评估住院成人鲍曼不动杆菌感染的依瓦环素治疗方案。采用随机效应模型合并95%置信区间的风险比（rr）。采用R统计软件对数据进行分析。结果：纳入了15项研究，共462例患者。人口主要由老年人组成，呼吸道感染是最常见的感染源（77.6%）。耐碳青霉烯鲍曼不动杆菌占可评估病例的84.4%。在全因死亡率（RR 1.06; 95% CI 0.46-2.47）、临床治愈率（RR 0.90; 95% CI 0.77-1.07）或微生物根除（RR 0.88; 95% CI 0.56-1.37）方面，依拉瓦环素和非依拉瓦环素方案没有统计学上的显著差异。在依拉瓦环素治疗的队列中，补充单臂汇总估计是有利的。结论：本荟萃分析加强了依瓦环素治疗耐药鲍曼不动杆菌感染有效性的证据基础，并支持在首选方案不可行的情况下考虑依瓦环素；需要足够有力的随机试验来确定最佳定位。

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

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

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.