PMID- 37767465
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231003
IS  - 2405-8440 (Print)
IS  - 2405-8440 (Electronic)
IS  - 2405-8440 (Linking)
VI  - 9
IP  - 10
DP  - 2023 Oct
TI  - Carbapenems versus beta-lactam and beta-lactamase inhibitors for treatment of 
      nosocomial pneumonia: A systematic review and meta-analysis.
PG  - e20108
LID - 10.1016/j.heliyon.2023.e20108 [doi]
LID - e20108
AB  - BACKGROUND: Carbapenems and beta-lactam and beta-lactamase inhibitors (BLBLIs) have 
      been used empirically in nosocomial pneumonia, but their efficacy and safety are 
      controversial. OBJECTIVE: We carried out a systematic review with meta-analysis 
      to evaluate the efficacy and safety of carbapenems versus BLBLIs against 
      nosocomial pneumonia. METHODS: PubMed, Embase, Cochrane Central Register of 
      Controlled Trials, CNKI, Wangfang, VIP and Sinomed were searched systematically 
      through April 29, 2023 for clinical trials comparing carbapenems with BLBLIs for 
      treatment of nosocomial pneumonia. Random-effects models were used to evaluate 
      the impact of treatment on the risk ratio (RR) of all-cause mortality, clinical 
      response, microbiologic response, resistance by Pseudomonas aeruginosa, adverse 
      effects (AEs), and serious adverse effects. The quality of the evidence was 
      assessed with the Cochrane risk of bias tool. The review was registerted in the 
      INPLASY (INPLASY202340113). RESULTS: Seven randomized controlled trials 
      containing 3306 patients met our inclusion criteria Our meta-analysis showed no 
      significant difference in all-cause mortality (RR = 0.88, 95% confidence interval 
      [CI] = 0.75-1.03, I(2) = 0%) or clinical cure (1.02, 0.96-1.09, 30%) or clinical 
      failure (1.19, 0.97-1.47, 0%) or microbiologic clinical cure (0.98, 0.89-1.06, 
      40%) or Pseudomonas aeruginosa resistance (RR 2.43, CI 0.86-6.81, 49%, P = 0.09) 
      or adverse events (0.98, 0.93-1.02, 0%) between carbapenems groups versus BLBLIs 
      groups, but a significant difference was found for severe adverse events (RR 
      0.83, CI 0.73-0.94, 0%). CONCLUSION: Differences in the prevalence of mortality, 
      clinical cure, or clinical failure were not observed between carbapenems groups 
      versus BLBLIs groups in terms of nosocomial pneumonia. The use of carbapenems was 
      linked to a tendency towards the emergence of P. aeruginosa resistance, however, 
      no statistically significant difference was observed.
CI  - (c) 2023 The Authors.
FAU - Cang, Huai Qin
AU  - Cang HQ
AD  - Department of Pharmacy, Affiliated Hospital of Qingdao University, China.
FAU - Quan, Xiang Hua
AU  - Quan XH
AD  - Department of Pharmacy, Affiliated Hospital of Qingdao University, China.
FAU - Chu, Xiang Hua
AU  - Chu XH
AD  - Department of Pharmacy, Affiliated Hospital of Qingdao University, China.
FAU - Liang, Yu
AU  - Liang Y
AD  - Department of Pharmacy, Affiliated Hospital of Qingdao University, China.
FAU - Yang, Xue
AU  - Yang X
AD  - Department of Pharmacy, Affiliated Hospital of Qingdao University, China.
FAU - Li, Jing
AU  - Li J
AD  - Department of Pharmacy, Affiliated Hospital of Qingdao University, China.
LA  - eng
PT  - Journal Article
DEP - 20230913
PL  - England
TA  - Heliyon
JT  - Heliyon
JID - 101672560
PMC - PMC10520732
OTO - NOTNLM
OT  - Carbapenem antibiotics
OT  - Meta-analysis
OT  - Nosocomial pneumonia
OT  - Systematic review
OT  - beta-lactam
OT  - beta-lactamase inhibitors
COIS- The authors declare that they have no known competing financial interests or 
      personal relationships that could have appeared to influence the work reported in 
      this paper.
EDAT- 2023/09/28 06:43
MHDA- 2023/09/28 06:44
PMCR- 2023/09/13
CRDT- 2023/09/28 04:16
PHST- 2023/01/09 00:00 [received]
PHST- 2023/08/24 00:00 [revised]
PHST- 2023/09/12 00:00 [accepted]
PHST- 2023/09/28 06:44 [medline]
PHST- 2023/09/28 06:43 [pubmed]
PHST- 2023/09/28 04:16 [entrez]
PHST- 2023/09/13 00:00 [pmc-release]
AID - S2405-8440(23)07316-4 [pii]
AID - e20108 [pii]
AID - 10.1016/j.heliyon.2023.e20108 [doi]
PST - epublish
SO  - Heliyon. 2023 Sep 13;9(10):e20108. doi: 10.1016/j.heliyon.2023.e20108. 
      eCollection 2023 Oct.