Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia
Background and Objectives: Nosocomial pneumonia caused by multidrug-resistant gram-negative bacteria presents a significant challenge for healthcare systems, as there are limited effective treatments available. This systematic review and meta-analysis aim to investigate the outcomes of colistin plu...
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2024-12-01
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| Series: | Iranian Journal of Microbiology |
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| Online Access: | https://ijm.tums.ac.ir/index.php/ijm/article/view/4673 |
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| author | Hazhir Moradi Zahra Sadat Sajadi-Javan Sarah Mousavi Soodabeh Rostami Bita Moradi Khaniabadi |
| author_facet | Hazhir Moradi Zahra Sadat Sajadi-Javan Sarah Mousavi Soodabeh Rostami Bita Moradi Khaniabadi |
| author_sort | Hazhir Moradi |
| collection | DOAJ |
| description |
Background and Objectives: Nosocomial pneumonia caused by multidrug-resistant gram-negative bacteria presents a significant challenge for healthcare systems, as there are limited effective treatments available. This systematic review and meta-analysis aim to investigate the outcomes of colistin plus meropenem combination therapy on nosocomial pneumonia.
Materials and Methods: An exhaustive search of PubMed, Scopus, Web of Science (WOS), and Embase databases was conducted, resulting in the extraction of 5 studies for qualitative assessment and meta-analysis. The study sample included 991 patients admitted with nosocomial pneumonia. The outcomes evaluated were clinical improvement, microbiological response, mortality, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE II) score, Charlson Comorbidity Index (CCI), Clinical Pulmonary Infection Score (CPIS), C-reactive protein (CRP) levels, procalcitonin (PCT) levels, and intensive care unit (ICU) duration.
Results: The results demonstrated that colistin plus meropenem combination therapy significantly improved clinical outcomes (OR = 1.37, 95% CI = 1.04-1.81, p = 0.027), reduced SOFA scores (OR = -0.28, 95% CI = -0.44 to -0.11, p = 0.001), and increased CCI scores (OR = 0.16, 95% CI = 0.02-0.29, p = 0.021) compared to other medications. However, other evaluated parameters did not show significant differences.
Conclusion: This meta-analysis indicates that colistin-meropenem combination therapy is superior to other colistin-based treatments for nosocomial pneumonia in terms of clinical improvement, SOFA score reduction, and CCI score increase. Nevertheless, other variables assessed did not exhibit remarkable differences between the treatment regimens.
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| format | Article |
| id | doaj-art-5e02b5ee73f7485da975af0335a999b4 |
| institution | Kabale University |
| issn | 2008-3289 2008-4447 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Microbiology |
| spelling | doaj-art-5e02b5ee73f7485da975af0335a999b42025-01-06T08:38:50ZengTehran University of Medical SciencesIranian Journal of Microbiology2008-32892008-44472024-12-0116610.18502/ijm.v16i6.17244Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumoniaHazhir Moradi0Zahra Sadat Sajadi-Javan1Sarah Mousavi2Soodabeh Rostami3Bita Moradi Khaniabadi4Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, IranNosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, IranNosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, IranNosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Background and Objectives: Nosocomial pneumonia caused by multidrug-resistant gram-negative bacteria presents a significant challenge for healthcare systems, as there are limited effective treatments available. This systematic review and meta-analysis aim to investigate the outcomes of colistin plus meropenem combination therapy on nosocomial pneumonia. Materials and Methods: An exhaustive search of PubMed, Scopus, Web of Science (WOS), and Embase databases was conducted, resulting in the extraction of 5 studies for qualitative assessment and meta-analysis. The study sample included 991 patients admitted with nosocomial pneumonia. The outcomes evaluated were clinical improvement, microbiological response, mortality, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE II) score, Charlson Comorbidity Index (CCI), Clinical Pulmonary Infection Score (CPIS), C-reactive protein (CRP) levels, procalcitonin (PCT) levels, and intensive care unit (ICU) duration. Results: The results demonstrated that colistin plus meropenem combination therapy significantly improved clinical outcomes (OR = 1.37, 95% CI = 1.04-1.81, p = 0.027), reduced SOFA scores (OR = -0.28, 95% CI = -0.44 to -0.11, p = 0.001), and increased CCI scores (OR = 0.16, 95% CI = 0.02-0.29, p = 0.021) compared to other medications. However, other evaluated parameters did not show significant differences. Conclusion: This meta-analysis indicates that colistin-meropenem combination therapy is superior to other colistin-based treatments for nosocomial pneumonia in terms of clinical improvement, SOFA score reduction, and CCI score increase. Nevertheless, other variables assessed did not exhibit remarkable differences between the treatment regimens. https://ijm.tums.ac.ir/index.php/ijm/article/view/4673Meropenem;Colistin;Multiple drug-resistance;Nosocomial infection;Pneumonia |
| spellingShingle | Hazhir Moradi Zahra Sadat Sajadi-Javan Sarah Mousavi Soodabeh Rostami Bita Moradi Khaniabadi Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia Iranian Journal of Microbiology Meropenem; Colistin; Multiple drug-resistance; Nosocomial infection; Pneumonia |
| title | Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia |
| title_full | Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia |
| title_fullStr | Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia |
| title_full_unstemmed | Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia |
| title_short | Systematic review and meta-analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia |
| title_sort | systematic review and meta analysis of colistin plus meropenem therapy for the treatment of nosocomial pneumonia |
| topic | Meropenem; Colistin; Multiple drug-resistance; Nosocomial infection; Pneumonia |
| url | https://ijm.tums.ac.ir/index.php/ijm/article/view/4673 |
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