International journal of antimicrobial agents
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Int. J. Antimicrob. Agents · Sep 2020
Meta AnalysisTocilizumab for severe COVID-19: a systematic review and meta-analysis.
This systemic review and meta-analysis aimed to assess the efficacy of tocilizumab for the treatment of severe coronavirus disease 2019 (COVID-19). Candidate studies up to 24 May 2020 were identified from PubMed, Cochrane Library, Embase, medRxiv and bioRxiv. Treatment outcomes included mortality, risk of intensive care unit (ICU) admission and the requirement for mechanical ventilation (MV). ⋯ However, these non-significant differences between the tocilizumab and control groups may have been the result of baseline characteristics of the tocilizumab group, which were more severe than those of the control group. Based on low-quality evidence, there is no conclusive evidence that tocilizumab would provide any additional benefit to patients with severe COVID-19. Therefore, further recommendation of tocilizumab for COVID-19 cases should be halted until high-quality evidence from randomised controlled trials is available.
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Int. J. Antimicrob. Agents · Nov 2018
Meta Analysis Comparative StudyBeta-lactam/beta-lactamase inhibitors versus carbapenem for bloodstream infections due to extended-spectrum beta-lactamase-producing Enterobacteriaceae: systematic review and meta-analysis.
Infections due to extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae pose a major public health threat due to poor outcomes and high mortality rates. A systematic review and meta-analysis was conducted to investigate the impact of intravenous beta-lactam/beta-lactamase inhibitors (BL-BLI), including piperacillin-tazobactam (PTZ), on mortality of participants with ESBL-producing Enterobacteriaceae bloodstream infections compared with carbapenem. ⋯ These findings suggest that there is no significant difference in 30-day mortality between BL-BLI, including PTZ and carbapenems, in treating ESBL-producing Enterobacteriaceae bloodstream infections. Moreover, intravenous BL-BLI, especially PTZ, may be considered as an alternative treatment for ESBL-producing Enterobacteriaceae bloodstream infections. Future studies are needed to validate these findings.
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Int. J. Antimicrob. Agents · Jan 2018
Review Meta AnalysisInhaled colistin monotherapy for respiratory tract infections in adults without cystic fibrosis: a systematic review and meta-analysis.
Inhaled colistin is becoming increasingly popular against respiratory tract infections caused by multidrug resistant (MDR) Gram-negative bacteria because it may overcome the problems associated with intravenous (IV) administration. ⋯ Inhaled colistin monotherapy may deserve further consideration as a mode for colistin administration for the treatment of respiratory tract infections caused by MDR A. baumannii and P. aeruginosa.
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Int. J. Antimicrob. Agents · Jan 2018
Review Meta AnalysisUse of evidence-based recommendations in an antibiotic care bundle for the intensive care unit.
To drive decisions on antibiotic therapy in the intensive care unit (ICU), we developed an antibiotic care bundle (ABC-Bundle) with evidence-based recommendations (EBRs) for antibiotic prescriptions. ⋯ The ABC-Bundle is a novel tool to improve delivery of appropriate antibiotic therapy to ICU patients. The low adherence in the prospective cohorts confirms the significant role that the ABC-Bundle could play in an antibiotic stewardship programme in the ICU setting.