{"title":"治疗耐碳青霉烯类革兰氏阴性菌感染的头孢他啶-阿维菌素联合疗法与单一疗法的比较：系统综述和荟萃分析。","authors":"Wei Hsu, Min-Hsiang Chuang, Wen-Wen Tsai, Chih-Cheng Lai, Hsin-Yu Lai, Hung-Jen Tang","doi":"10.1007/s15010-024-02277-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis was conducted to compare the efficacy of ceftazidime-avibactam combination therapy with that of monotherapy in the treatment of carbapenem-resistant Gram-negative bacterial (CR-GNB).</p><p><strong>Methods: </strong>A literature search of PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov was conducted until September 1, 2023. Only studies that compared CZA combination therapy with monotherapy for CR-GNB infections were included.</p><p><strong>Results: </strong>A total of 25 studies (23 retrospective observational studies and 2 prospective studies) involving 2676 patients were included. There was no significant difference in 30-day mortality between the study group receiving combination therapy and the control group receiving monotherapy (risk ratio [RR] 0.91; 95% confidence interval [CI] 0.71-1.18). In addition, no significant differences were observed between the study and the control group in terms of in-hospital mortality (RR 1.00; 95% CI 0.79-1.27), 14-day mortality (RR 1.54; 95% CI 0.24-9.91), 90-day mortality (RR 1.18; 95% CI 0.62-2.22), and clinical cure rate (RR 0.95; 95% CI 0.84-1.08). However, the combination group had a borderline higher microbiological eradication rate than the control group (RR 1.15; 95% CI 1.00-1.32).</p><p><strong>Conclusions: </strong>Compared to monotherapy, CZA combination therapy did not yield additional clinical benefits. However, combination therapy may be associated with favorable microbiological outcomes.</p>","PeriodicalId":13600,"journal":{"name":"Infection","volume":null,"pages":null},"PeriodicalIF":5.4000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Ceftazidime-avibactam combination therapy versus monotherapy for treating carbapenem-resistant gram-negative infection: a systemic review and meta-analysis.\",\"authors\":\"Wei Hsu, Min-Hsiang Chuang, Wen-Wen Tsai, Chih-Cheng Lai, Hsin-Yu Lai, Hung-Jen Tang\",\"doi\":\"10.1007/s15010-024-02277-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This meta-analysis was conducted to compare the efficacy of ceftazidime-avibactam combination therapy with that of monotherapy in the treatment of carbapenem-resistant Gram-negative bacterial (CR-GNB).</p><p><strong>Methods: </strong>A literature search of PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov was conducted until September 1, 2023. 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引用次数: 0
摘要
背景：本荟萃分析旨在比较头孢他啶-阿维菌素联合疗法与单一疗法治疗耐碳青霉烯类革兰氏阴性菌（CR-GNB）的疗效：方法：对PubMed、Embase、Cochrane图书馆和ClinicalTrials.gov进行文献检索，直至2023年9月1日。结果：共纳入 25 项研究（23 项回顾性研究）：结果：共纳入25项研究（23项回顾性观察研究和2项前瞻性研究），涉及2676名患者。接受联合疗法的研究组与接受单一疗法的对照组在 30 天死亡率方面无明显差异（风险比 [RR] 0.91；95% 置信区间 [CI] 0.71-1.18）。此外，在院内死亡率（RR 1.00；95% CI 0.79-1.27）、14 天死亡率（RR 1.54；95% CI 0.24-9.91）、90 天死亡率（RR 1.18；95% CI 0.62-2.22）和临床治愈率（RR 0.95；95% CI 0.84-1.08）方面，研究组与对照组之间未观察到明显差异。然而，联合治疗组的微生物根除率略高于对照组（RR 1.15；95% CI 1.00-1.32）：结论：与单一疗法相比，CZA联合疗法并未产生额外的临床疗效。结论：与单一疗法相比，CZA 联合疗法并没有带来更多临床益处，但联合疗法可能会带来良好的微生物效果。
Ceftazidime-avibactam combination therapy versus monotherapy for treating carbapenem-resistant gram-negative infection: a systemic review and meta-analysis.
Background: This meta-analysis was conducted to compare the efficacy of ceftazidime-avibactam combination therapy with that of monotherapy in the treatment of carbapenem-resistant Gram-negative bacterial (CR-GNB).
Methods: A literature search of PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov was conducted until September 1, 2023. Only studies that compared CZA combination therapy with monotherapy for CR-GNB infections were included.
Results: A total of 25 studies (23 retrospective observational studies and 2 prospective studies) involving 2676 patients were included. There was no significant difference in 30-day mortality between the study group receiving combination therapy and the control group receiving monotherapy (risk ratio [RR] 0.91; 95% confidence interval [CI] 0.71-1.18). In addition, no significant differences were observed between the study and the control group in terms of in-hospital mortality (RR 1.00; 95% CI 0.79-1.27), 14-day mortality (RR 1.54; 95% CI 0.24-9.91), 90-day mortality (RR 1.18; 95% CI 0.62-2.22), and clinical cure rate (RR 0.95; 95% CI 0.84-1.08). However, the combination group had a borderline higher microbiological eradication rate than the control group (RR 1.15; 95% CI 1.00-1.32).
Conclusions: Compared to monotherapy, CZA combination therapy did not yield additional clinical benefits. However, combination therapy may be associated with favorable microbiological outcomes.
期刊介绍：
Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings.
The journal covers a wide range of topics, including:
Etiology: The study of the causes of infectious diseases.
Pathogenesis: The process by which an infectious agent causes disease.
Diagnosis: The methods and techniques used to identify infectious diseases.
Treatment: The medical interventions and strategies employed to treat infectious diseases.
Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies.
Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections.
In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.
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