Wang Lei, Tong Xiang, Huang Jizhen, Zhang Li, Wang Dongguang, Wu Man, Liu Tao, Fan Hong
Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China.
Front Pharmacol. 2020 Jan 30;10:1673. doi: 10.3389/fphar.2019.01673. eCollection 2019.
The role of combination treatment in the management of carbapenem-resistant Enterobacteriaceae infections (CRE) is still unclear. There have been no meta-analysis comparing the efficiency of triple therapy in treating CRE infections with that of double therapy. In this perspective, we conducted a meta-analysis to clarify whether triple therapy is superior to double therapy in treating patients with CRE infections.
We performed a systematic review, using PubMed and Embase without any restrictions until October 2019. Risk ratio (RR) with 95% CI were pooled to evaluate the effect of intervention.
A total of 33 studies with 1,441 subjects were identified. Pooled analysis showed that triple therapy was not associated with a reduced mortality compared with double therapy (HR 0.99 95% CI 0.85-1.14, P = 0.85).
This meta-analysis suggests that triple therapy is not superior to double therapy in the treatment of patients with CRE infections, although the quality of evidence is generally low based on current literatures. Future well-defined, randomized controlled trials will be required to elucidate the role of triple therapy in the treatment of CRE infections.
联合治疗在耐碳青霉烯类肠杆菌科细菌感染（CRE）管理中的作用仍不明确。尚无荟萃分析比较三联疗法与双联疗法治疗CRE感染的疗效。就此，我们进行了一项荟萃分析，以阐明三联疗法在治疗CRE感染患者方面是否优于双联疗法。
我们进行了一项系统评价，使用PubMed和Embase数据库，检索截至2019年10月的数据，无任何限制。汇总95%置信区间的风险比（RR）以评估干预效果。
共纳入33项研究，1441名受试者。汇总分析表明，与双联疗法相比，三联疗法并未降低死亡率（HR 0.99，95% CI 0.85 - 1.14，P = 0.85）。
这项荟萃分析表明，在治疗CRE感染患者方面，三联疗法并不优于双联疗法，尽管基于当前文献证据质量普遍较低。未来需要开展明确的随机对照试验，以阐明三联疗法在治疗CRE感染中的作用。
