PMID- 36042624
OWN - NLM
STAT- MEDLINE
DCOM- 20220901
LR  - 20221115
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 101
IP  - 34
DP  - 2022 Aug 26
TI  - Efficacy and safety of optional parenteral antimicrobial therapy for complicated 
      skin and soft tissue infections: A systematic review and Bayesian network 
      meta-analysis.
PG  - e30120
LID - 10.1097/MD.0000000000030120 [doi]
LID - e30120
AB  - BACKGROUND: Skin and soft tissue infections (SSTIs) carry significant economic 
      burden, as well as morbidity and mortality, especially when caused by 
      methicillin-resistant Staphylococcus aureus. This study aims to investigate the 
      efficacy and safety of optional antimicrobial therapy for the treatment of 
      complicated SSTIs (cSSTIs). METHODS: We searched PubMed, Medline (Via Ovid SP), 
      Embase (Via Ovid SP), and the Cochrane Central Register of Controlled Trials from 
      their inception to March 22, 2021 for randomized controlled trials (RCTs) that 
      studied the use of optional antimicrobial therapy for cSSTIs. Citations' 
      screening, study selection, data extraction, and risk of bias assessment were 
      independently performed by 2 authors. The primary outcomes were clinical and 
      microbiological treatment success, and adverse events (AEs) were also assessed. 
      RESULTS: A total of 48 trials covering 24,381 patients assessing 20 types of 
      antimicrobial treatment modalities were included. Overall, omadacycline was 
      associated with the highest beneficial effect on clinical and microbiological 
      treatment success and with the largest rank probability based on surface under 
      the cumulative ranking curve values, avarofloxacin was closely followed. Both 
      had, however, omadacycline was related to moderately safety profiles. Lefamulin 
      ranked as the best option was associated with the lowest risk of severe AEs. 
      Subgroup analysis showed similar results. The quality of primary outcomes was 
      moderate to low. CONCLUSIONS: The use of omadacycline was associated with higher 
      rates of clinical and microbiological treatment success for the treatment of 
      cSSTIs, with a relative low risk of AEs. Due to the limitations of the included 
      RCTs, high-quality and well-designed RCTs are needed to further confirm the 
      results.
CI  - Copyright (c) 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Li, Huijuan
AU  - Li H
AD  - Department of Pharmacy, The People's Hospital of Guangxi Zhuang Autonomous 
      Region, Nanning, People's Republic of China.
FAU - Liang, Xueyan
AU  - Liang X
FAU - Mo, Guangyan
AU  - Mo G
FAU - Guo, Sitong
AU  - Guo S
FAU - Chen, Xiaoyu
AU  - Chen X
FAU - Li, Yan
AU  - Li Y
AUID- ORCID: 0000-0003-3901-0727
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Anti-Infective Agents)
SB  - IM
MH  - Anti-Bacterial Agents/adverse effects
MH  - *Anti-Infective Agents/adverse effects
MH  - Humans
MH  - Network Meta-Analysis
MH  - *Skin Diseases, Bacterial/drug therapy
MH  - *Soft Tissue Infections/drug therapy
PMC - PMC9410650
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2022/09/01 06:00
MHDA- 2022/09/02 06:00
PMCR- 2022/08/26
CRDT- 2022/08/31 01:11
PHST- 2022/08/31 01:11 [entrez]
PHST- 2022/09/01 06:00 [pubmed]
PHST- 2022/09/02 06:00 [medline]
PHST- 2022/08/26 00:00 [pmc-release]
AID - 00005792-202208260-00043 [pii]
AID - 10.1097/MD.0000000000030120 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2022 Aug 26;101(34):e30120. doi: 
      10.1097/MD.0000000000030120.