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使用头孢他啶/阿维巴坦、头孢洛扎/他唑巴坦和美罗培南/瓦博巴坦治疗多重耐药革兰氏阴性菌感染的临床结局的荟萃分析。

Meta-analysis of Clinical Outcomes Using Ceftazidime/Avibactam, Ceftolozane/Tazobactam, and Meropenem/Vaborbactam for the Treatment of Multidrug-Resistant Gram-Negative Infections.

作者信息

Wilson Geneva M, Fitzpatrick Margaret, Walding Kyle, Gonzalez Beverly, Schweizer Marin L, Suda Katie J, Evans Charlesnika T

机构信息

Center of Innovation for Complex Chronic Healthcare (CINCCH), Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois, USA.

Loyola Medical Center, Maywood, Illinois, USA.

出版信息

Open Forum Infect Dis. 2021 Jan 5;8(2):ofaa651. doi: 10.1093/ofid/ofaa651. eCollection 2021 Feb.

Abstract

Ceftolozane-tazobactam (C/T), ceftazidime-avibactam (C/A), and meropenem/vaborbactam (M/V) are new beta-lactam/beta-lactamase combination antibiotics commonly used to treat multidrug-resistant (MDRPA) and carbapenem-resistant (CRE) infections. This review reports the clinical success rates for C/T, C/A, and M/V. PubMed and EMBASE were searched from January 1, 2012, through September 2, 2020, for publications detailing the use of C/T, C/A, and M/V. A meta-analysis determined the pooled effectiveness of C/T, C/A, and M/V. The literature search returned 1950 publications; 29 publications representing 1620 patients were retained. Pneumonia was the predominant infection type (49.8%). MDRPA was the major pathogen treated (65.3%). The pooled clinical success rate was 73.3% (95% CI, 68.9%-77.5%). C/T, C/A, or M/V resistance was reported in 8.9% of the population. These antibiotics had a high clinical success rate in patients with complicated infections and limited treatment options. Larger studies comparing C/T, C/A, and M/V against other antibiotic regimens are needed.

摘要

头孢洛扎/他唑巴坦(C/T)、头孢他啶/阿维巴坦(C/A)和美罗培南/法硼巴坦(M/V)是新型β-内酰胺类/β-内酰胺酶抑制剂联合抗生素,常用于治疗多重耐药铜绿假单胞菌(MDRPA)感染和耐碳青霉烯类肠杆菌科细菌(CRE)感染。本综述报告了C/T、C/A和M/V的临床成功率。检索了2012年1月1日至2020年9月2日期间的PubMed和EMBASE数据库,以查找详细介绍C/T、C/A和M/V使用情况的出版物。通过荟萃分析确定了C/T、C/A和M/V的综合有效性。文献检索共返回1950篇出版物;最终纳入了29篇代表1620例患者的文献。肺炎是主要的感染类型(49.8%)。MDRPA是接受治疗的主要病原体(65.3%)。综合临床成功率为73.3%(95%CI,68.9%-77.5%)。8.9%的患者报告对C/T、C/A或M/V耐药。这些抗生素在治疗复杂感染且治疗选择有限的患者中具有较高的临床成功率。需要开展更大规模的研究,比较C/T、C/A和M/V与其他抗生素治疗方案的疗效。

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