Ceftazidime-avibactam and aztreonam combination for Carbapenem-resistant Enterobacterales bloodstream infections with presumed Metallo-ß-lactamase production: a systematic review and meta-analysis.
Expert Rev Anti Infect Ther
; 22(4): 203-209, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38258529
ABSTRACT
INTRODUCTION:
Carbapenem-resistant Enterobacterales (CRE) due to Metallo-ß-lactamase (MBL) production are treated with either polymyxins or the novel combination of ceftazidime-avibactam and aztreonam (AA). This study aims to evaluate the 30-day mortality of AA in patients with BSI caused by MBL-CRE infections.METHODOLOGY:
In this systematic review and meta-analysis, all articles up to June 2023 were screened using search terms like 'CRE', 'MBL', 'AA' and 'polymyxins'. The risk ratio for AA vs polymyxins was pooled using a random-effect model, and the results were represented by a point estimate with a 95% confidence interval.RESULTS:
After removing the duplicates, the titles and abstracts of 455 articles were screened, followed by a full-text screening of 50 articles. A total of 24 articles were included for systematic review, and four comparative studies were included in the meta-analysis. All four studies had a moderate or serious risk of bias. The pooled risk ratio for 30-day mortality for AA vs. polymyxins was 0.51 (95%CI 0.34-0.76), p < 0.001. There was no significant heterogeneity.CONCLUSION:
The meta-analysis from studies with a high risk of bias shows that AA is associated with lesser 30-day mortality when compared to polymyxins in patients with MBL-producing CRE BSI. Registration with PROSPERO- CRD42023433608.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Aztreonam
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Ceftazidima
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Infecções por Enterobacteriaceae
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Compostos Azabicíclicos
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Enterobacteriáceas Resistentes a Carbapenêmicos
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Antibacterianos
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Índia