Elda Righi, Luigia Scudeller, Margherita Chiamenti, Kamilia Abdelraouf, Thomas Lodise, Elena Carrara, Alessia Savoldi, Dario Menghin, Gloria Pellizzari, Sally Ellis, Francois Franceschi, Laura Piddock, Chiara Rebuffi, Maurizio Sanguinetti, Evelina Tacconelli
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引用次数: 2
摘要
目的:目前尚无证据确定联合治疗方案与单一治疗方案在抗碳青霉烯耐药(CR)革兰氏阴性菌感染方面的优势。体内模型可以模拟人类感染的病理生理，并评估抗生素的疗效。我们的目的是研究抗生素组合对鲍曼不动杆菌、铜绿假单胞菌和肠杆菌科感染的死亡率和疾病负担的体内影响，并对现有知识进行公正的概述。这项研究的结果可以帮助优先考虑未来针对CR细菌最有希望的治疗方法的研究。方法和分析:本方案采用动物干预研究系统评价方案(sycle)核对表制定。出版物将从PubMed, Scopus, Embase和Web of Science收集。将使用协作方法对实验研究动物数据进行meta分析和审查的质量检查表以及sycle的偏倚风险工具。如果荟萃分析似乎可行，将分析ES和95% CI。研究间的异质性将通过I2检验进行评估。如有可能，将进行亚组荟萃分析，以评估研究对治疗效果的影响。漏斗图将用于评估发表偏倚的风险。传播:这项系统评价和荟萃分析是一个更广泛的研究合作项目的一部分，该项目是治疗成人和儿童碳青霉烯耐药细菌引起的脓毒症的联合疗法:证据和惯例(COHERENCE)研究，该研究还包括体外和人体研究的分析。数据将在国际会议上发表，结果将发表在同行评议的期刊上。普洛斯彼罗注册号:CRD42019128104(可在:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019128104)。
In vivo studies on antibiotic combination for the treatment of carbapenem-resistant Gram-negative bacteria: a systematic review and meta-analysis protocol.
Objective: There is poor evidence to determine the superiority of combination regimens versus monotherapy against infections due to carbapenem-resistant (CR) Gram-negative bacteria. In vivo models can simulate the pathophysiology of infections in humans and assess antibiotic efficacy. We aim to investigate in vivo effects of antibiotic combination on mortality and disease burden for infections due to CR Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacteriaceae and provide an unbiased overview of existing knowledge. The results of the study can help prioritising future research on the most promising therapies against CR bacteria.
Methods and analysis: This protocol was formulated using the Systematic Review Protocol for Animal Intervention Studies (SYRCLE) Checklist. Publications will be collected from PubMed, Scopus, Embase and Web of Science. Quality checklists adapted by Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies and SYRCLE's risk of bias tool will be used. If the meta-analysis seems feasible, the ES and the 95% CI will be analysed. The heterogeneity between studies will be assessed by I2 test. Subgroup meta-analysis will be performed when possible to assess the impact of the studies on efficacy of the treatments. Funnel plotting will be used to evaluate the risk of publication bias.
Dissemination: This systematic review and meta-analysis is part of a wider research collaboration project, the COmbination tHErapy to treat sepsis due to carbapenem-Resistant bacteria in adult and paediatric population: EvideNCE and common practice (COHERENCE) study that includes also the analyses of in vitro and human studies. Data will be presented at international conferences and the results will be published in peer-reviewed journals.
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