Next Article in Journal
Salivary Biomarkers of Oxidative Stress in Children with Chronic Kidney Disease
Previous Article in Journal
Epithelial-Mesenchymal Transition with Malignant Transformation Leading Multiple Metastasis from Disseminated Peritoneal Leiomyomatosis
Article Menu
Issue 8 (August) cover image

Export Article

Open AccessArticle
J. Clin. Med. 2018, 7(8), 208; https://doi.org/10.3390/jcm7080208

Intravenous Colistin Monotherapy versus Combination Therapy against Carbapenem-Resistant Gram-Negative Bacteria Infections: Meta-Analysis of Randomized Controlled Trials

1
Department of Pharmacy, Chi Mei Medical Center, Liouying, Tainan 73657, Taiwan
2
Department of Intensive Care Medicine Chi Mei Medical Center, Liouying, Tainan 73657, Taiwan
3
Department of Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan
*
Author to whom correspondence should be addressed.
Received: 24 July 2018 / Revised: 2 August 2018 / Accepted: 9 August 2018 / Published: 10 August 2018
Full-Text   |   PDF [1245 KB, uploaded 10 August 2018]   |  

Abstract

This meta-analysis aims to compare intravenous colistin monotherapy and colistin-based combination therapy against carbapenem-resistant gram-negative bacteria (GNB) infections. PubMed, Embase, and Cochrane databases were searched up to July 2018. Only randomized controlled trials (RCTs) evaluating colistin alone and colistin-based combination therapy in the treatment of carbapenem-resistant GNB infections were included. The primary outcome was all-cause mortality. Five RCTs including 791 patients were included. Overall, colistin monotherapy was associated with a risk ratio (RR) of 1.03 (95% confidence interval (CI), 0.89–1.20, I2 = 0%) for all-cause mortality compared with colistin-based combination therapy. The non-significant difference was also detected in infection-related mortality (RR, 1.23, 95% CI, 0.91–1.67, I2 = 0%) and microbiologic response (RR, 0.86, 95% CI, 0.72–1.04, I2 = 62%). In addition, no significant difference was observed in the subgroup analysis—high or low dose, with or without a loading dose, carbapenem-resistant Acinetobacter baumannii infections, and in combination with rifampicin. Finally, colistin monotherapy was not associated with lower nephrotoxicity than colistin combination therapy (RR, 0.98; 95% CI, 0.84–1.21, I2 = 0%). Based on the analysis of the five RCTs, no differences were found between colistin monotherapy and colistin-based combination therapy against carbapenem-resistant GNB infections, especially for A. baumannii infections. View Full-Text
Keywords: colistin; monotherapy; combination therapy; carbapenem-resistant bacteria colistin; monotherapy; combination therapy; carbapenem-resistant bacteria
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
SciFeed

Share & Cite This Article

MDPI and ACS Style

Cheng, I.-L.; Chen, Y.-H.; Lai, C.-C.; Tang, H.-J. Intravenous Colistin Monotherapy versus Combination Therapy against Carbapenem-Resistant Gram-Negative Bacteria Infections: Meta-Analysis of Randomized Controlled Trials. J. Clin. Med. 2018, 7, 208.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top