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。

IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Expert Review of Anti-infective Therapy Pub Date : 2024-07-01 Epub Date: 2024-03-05 DOI:10.1080/14787210.2024.2324940
Chih-Chung Lin, Jheng-Yen Wu, Po-Yu Huang, Hui-Lin Sung, Yu-Chun Tung, Chih-Cheng Lai, Yu-Feng Wei, Pin-Kuei Fu
{"title":"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。","authors":"Chih-Chung Lin, Jheng-Yen Wu, Po-Yu Huang, Hui-Lin Sung, Yu-Chun Tung, Chih-Cheng Lai, Yu-Feng Wei, Pin-Kuei Fu","doi":"10.1080/14787210.2024.2324940","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; <i>p</i> = 0.001; I<sup>2</sup> = 4.52%) and a shorter MV duration (SMD, -0.76; 95% CI, -1.37 to -0.16; <i>p</i> = 0.01; I<sup>2</sup> = 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparing prolonged infusion to intermittent infusion strategies for beta-lactam antibiotics in patients with gram-negative bacterial infections: a systematic review and meta-analysis.\",\"authors\":\"Chih-Chung Lin, Jheng-Yen Wu, Po-Yu Huang, Hui-Lin Sung, Yu-Chun Tung, Chih-Cheng Lai, Yu-Feng Wei, Pin-Kuei Fu\",\"doi\":\"10.1080/14787210.2024.2324940\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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; <i>p</i> = 0.001; I<sup>2</sup> = 4.52%) and a shorter MV duration (SMD, -0.76; 95% CI, -1.37 to -0.16; <i>p</i> = 0.01; I<sup>2</sup> = 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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":12213,\"journal\":{\"name\":\"Expert Review of Anti-infective Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Expert Review of Anti-infective Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/14787210.2024.2324940\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/5 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Anti-infective Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14787210.2024.2324940","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/5 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

摘要

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。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Comparing prolonged infusion to intermittent infusion strategies for beta-lactam antibiotics in patients with gram-negative bacterial infections: a systematic review and meta-analysis.

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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
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.
期刊最新文献
The opportunities and challenges of epigenetic approaches to manage herpes simplex infections. Potential activity of nanomaterials to combat SARS-CoV-2 and mucormycosis ‎coinfection‎. Clinical effectiveness of oral antivirals for non-hospitalized adult COVID-19 patients aged 18-60 years. Is self-medication with antibiotics among the public a global concern: a mixed-methods systematic review. Continuous care engagement in clinical practice: perspectives on selected current strategies for people with HIV in the United States.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1