Comparison of piperacillin/tazobactam and imipenem/cilastatin, both in combination with tobramycin, administered every 6h for treatment of nosocomial pneumonia

Joshi, Manjari; Metzler, Michael H.; McCarthy, Mary C.; Olvey, Stephen E.; Kassira, Wedad; Cooper, Angel

doi:10.1016/j.rmed.2006.01.004

Cited by 45 publications

(79 citation statements)

References 33 publications

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“…From these, 51 RCTs did not meet the inclusion criteria of the current meta-analysis for the reasons detailed in figure 1. Thus, 12 RCTs [64][65][66][67][68][69][70][71][72][73][74][75] were included in the current meta-analysis. Table 1 lists the characteristics of the 12 RCTs [64][65][66][67][68][69][70][71][72][73][74][75] included in the meta-analysis.…”

Section: Data Analysis and Statistical Methodsmentioning

confidence: 99%

“…The mean (range) quality score of the included RCTs was 2.42 (1-5), which was considered good. The quality of five RCTs [64][65][66][67]74] was high (o3), while the quality of seven [68][69][70][71][72][73]75] was low (f2). The proportion of patients under mechanical ventilation was 100% in three trials [67,68,71], .70% in five trials [64-66, 72, 74] and 50% in two RCTs [69,75], while the remaining RCTs [70,73] did not provide relevant data.…”

Section: Data Analysis and Statistical Methodsmentioning

confidence: 99%

“…The proportion of patients under mechanical ventilation was 100% in three trials [67,68,71], .70% in five trials [64-66, 72, 74] and 50% in two RCTs [69,75], while the remaining RCTs [70,73] did not provide relevant data. In one RCT, patients who developed pneumonia during their stay in a chronic care facility were also included in the study [64]. The demographic characteristics of patients also varied between different studies.…”

Section: Data Analysis and Statistical Methodsmentioning

confidence: 99%

“…Imipenem/ cilastatin or meropenem was administered in eight [64-66, 68, 69, 71, 74, 75] and four RCTs [67,70,72,73], respectively. Imipenem/cilastatin was compared with fluoroquinolones in three RCTs (specifically, levofloxacin [65] and ciprofloxacin [68,74]) and with other b-lactams in five trials (specifically, piperacillin/tazobactam [64,69], aztreonam [71], cefepime [66] and ceftazidime [75]). Meropenem was compared with the combination of a cephalosporin (ceftazidime [67,72,73] and cefuroxime [70]) with an aminoglycoside (amikacin [67,73], gentamicin [70] and tobramycin [72]).…”

Section: Administration Of Study Drugsmentioning

confidence: 99%

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Carbapenems for the treatment of immunocompetent adult patients with nosocomial pneumonia

Siempos

Vardakas²,

Manta³

et al. 2007

Eur Respir J

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The comparative effectiveness and safety of carbapenems with other b-lactams and fluoroquinolones for the empirical treatment of patients with hospital-acquired pneumonia remains controversial.In the present study, a meta-analysis of 12 relevant randomised controlled trials was performed. Overall, carbapenems were associated with lower mortality than fluoroquinolones or b-lactams, alone or in combination with aminoglycosides (odds ratio 0.72, 95% confidence interval 0.55-0.95). There was no difference between the compared antibiotics regarding treatment success (1.08, 0.91-1.29), microbiological success (1.04, 0.72-1.50) or development of adverse effects (0.81, 0.46-1.43). In the subset of patients with Pseudomonas aeruginosa pneumonia, carbapenems were associated with lower treatment success (0.42, 0.22-0.82) and lower eradication of P. strains (0.50, 0.24-0.89).Carbapenems are equivalent to fluoroquinolones or b-lactams, alone or in combination with aminoglycosides, for the empirical treatment of immunocompetent adult patients with hospitalacquired pneumonia. However, there is limited evidence, based predominantly on unblinded randomised controlled trials, that carbapenems are associated with lower mortality than the comparators; this association was not observed in a subset analysis of randomised controlled trials with a high methodological quality score. In patients with Pseudomonas aeruginosa pneumonia, carbapenems are associated with worse outcomes than the comparators.

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Section: Data Analysis and Statistical Methodsmentioning

confidence: 99%

Section: Data Analysis and Statistical Methodsmentioning

confidence: 99%

Section: Data Analysis and Statistical Methodsmentioning

confidence: 99%

Section: Administration Of Study Drugsmentioning

confidence: 99%

See 2 more Smart Citations

Carbapenems for the treatment of immunocompetent adult patients with nosocomial pneumonia

Siempos

Vardakas²,

Manta³

et al. 2007

Eur Respir J

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“…Bu çal ma antibiyotik kar la t rma çal mas olmad için antibiyotiklere özel yan t oranlar de erlendirilmemi tir. Literatürde HKP'de ba ar oranlar %33 ile %68 aras nda de i mekte olup bizim sonuçlar m zla benzerlik göstermektedir [10,13].…”

Section: Tarti Maunclassified

The Importance of Pathogen Identification in the Success of Treatment of Hospital Acquired Pneumonias

Edis¹,

Hatipoğlu²,

Yılmam³

et al. 2010

Tur Toraks Der

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Objective: The aim of this study was to determine the effects of identification of the pathogens and specific and appropriate treatments, and the success of these treatments for subjects who acquired HAP non-ICU. Material and Method:The analyzed data was obtained from the records of 154 consecutive HAP patients who acquired pneumonia non-ICU. We investigated whether the factor was identified, whether patients received a specific therapy according to the results of a culture antibiogram, and whether the patients received appropriate antibiotics therapy initially. Results:When the groups treated specifically (n=78) and empirically (n=76) were compared, there were no significant differences between the clinical success rates. The difference was not significant between the group given an appropriate antibiotherapy initially (n=42) and the group whose initial therapy was changed according to the culture antibiogram after the factor was found (n=36). When the group given appropriate initial antibiotherapy (n=42) was compared with all the other patients (n=112), the difference between the clinical success rates was not significant. The most remarkable result of the study was the success rate being significantly higher in the group in which the pathogen could not be identified (n=66) compared with the group in (n=88) which the pathogen was identified (p=0.022). Conclusion:The clinical success rate was low in microorganismcaused HAPs with a potential for drug resistance and having the characteristic of developing rapid resistance, such as Acinetobacter spp. and Pseudomonas spp, even though specific treatment was administered. These results indicate that the prevention of infections that occur with such microorganisms is more important than the treatment. Etkenin tespit edilip edilememesinin, etkenin erken tespitinin, kültür antibiyogram sonucuna göre spesifik tedavi al p alamaman n, ba lang çta uygun antibiyotik tedavisi alman n klinik ba ar oranlar ile ili kisi x 2 yöntemiyle kar la t r ld . Bulgular: Spesifik tedavi verilen grup (n=78) ile sadece ampirik tedavi verilebilen grup kar la t r ld nda (n=76) klinik ba ar oranlar aras nda anlaml fark saptanmad . Ba lang çta uygun antibiyoterapi verilen grup (n=42) ile etken tespit edildikten sonra kültür antibiyograma göre ba lang ç tedavisi de i tirilen (n=36) grup kar la t r ld nda klinik ba ar oranlar aras ndaki fark anlams z bulundu. Ba lang çta uygun antibiyoterapi verilen grup (n=42) ile di er tüm hastalar kar la t r ld nda da (n=112) klinik ba ar oranlar aras nda fark anlams z bulundu. Çal man n en ilginç sonucu ise etkenin tespit edilemedi i grupta (n=66) tespit edilen gruba göre (n=88) tedavi ba ar s n n anlaml biçim-de yüksek bulunmas yd (p=0.022).Sonuç: Acinetobacter spp. ve Pseudomonas spp. gibi çok ilaca direnç potansiyeli ta yan ve h zl direnç geli tirebilme özelli ine sahip mikroorganizmalarla olu an HKP'lerde spesifik tedavi verilse dahi klinik ba ar oranlar dü üktür. Bu sonuç, bu tip özellik-lere sahip mikroorganizmalarla olu acak enfeksiyonlar önleme-nin, te...

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

Egi

Ogura

Yatabe

et al. 2021

Acute Medicine & Surgery

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The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created as revised from J‐SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high‐quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J‐SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU‐acquired weakness [ICU‐AW], post‐intensive care syndrome [PICS], and body temperature management). The J‐SSCG 2020 covered a total of 22 areas with four additional new areas (patient‐ and family‐centered care, sepsis treatment system, neuro‐intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large‐scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE‐based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J‐SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

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Comparison of piperacillin/tazobactam and imipenem/cilastatin, both in combination with tobramycin, administered every 6h for treatment of nosocomial pneumonia

Cited by 45 publications

References 33 publications

Carbapenems for the treatment of immunocompetent adult patients with nosocomial pneumonia

Carbapenems for the treatment of immunocompetent adult patients with nosocomial pneumonia

The Importance of Pathogen Identification in the Success of Treatment of Hospital Acquired Pneumonias

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020)

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