Mortality and clinical cure rates for pneumonia: a systematic review, meta-analysis, and trial sequential analysis of randomized control trials comparing bactericidal and bacteriostatic antibiotic treatments

Abstract

Mortality and clinical cure rates for pneumonia: A systematic review, meta-analysis, and trial sequential analysis of randomized control trials comparing bactericidal and bacteriostatic antibiotic treatments, Clinical Microbiology and Infection, https://doi.org/10.1016/j.cmi.2021.12.021. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Growth Arrest of Staphylococcus aureus Induces Daptomycin Tolerance via Cell Wall Remodelling

“…The reason why some antibiotics kill bacteria and others inhibit growth remains the subject of debate almost 80 years after penicillin was first used clinically ( 4 – 7 ). While there is currently no evidence to indicate that bactericidal antibiotics lead to better outcomes for patients than do bacteriostatic drugs ( 59 – 62 ), there is growing evidence that antibiotic tolerance is an underappreciated cause of treatment failure ( 13 , 15 , 63 – 65 ), and tolerance has also been shown to be a stepping stone to resistance ( 16 , 17 ). A recent clinical example of this comes from a patient with relapsing MRSA bacteremia that was initially caused by a daptomycin-tolerant strain but gave rise to isolates that were daptomycin nonsusceptible during subsequent periods of relapse ( 66 ).…”

Growth arrest ofStaphylococcus aureusinduces daptomycin tolerance via cell wall remodelling

“…The reason why some antibiotics kill bacteria and others inhibit growth remains the subject of debate almost 80 years after penicillin was first used clinically [4,5,6,7]. Whilst there is currently no evidence to indicate that bactericidal antibiotics lead to better outcomes for patients than bacteriostatic drugs [52,53,54,55], there is growing evidence that antibiotic tolerance is an underappreciated caused of treatment failure [13,15,56,57,58]. Antibiotic tolerance has also been shown to be a stepping-stone to resistance [16,17].…”

Antibiotics Modulate Variable Immunological Responses in Sepsis- A Narrative Review

“…Bactericidal antimicrobials are traditionally considered superior to bacteriostatic antimicrobials, as the former directly kills pathogens while bacteriostatic antimicrobial therapy halts the growth of the micro-organisms (16,17). The formal definition of a bactericidal antibiotic is a ratio of Minimum Bactericidal Concentration (MBC) to Minimum Inhibitory Concentration (MIC) <4, whereas a bacteriostatic agent has an MBC: MIC ratio >4 (16,17). This definition however is arbitrary with certain bacteriostatic antibiotics being able to kill pathogens at higher concentrations (16,17).…”

“…The formal definition of a bactericidal antibiotic is a ratio of Minimum Bactericidal Concentration (MBC) to Minimum Inhibitory Concentration (MIC) <4, whereas a bacteriostatic agent has an MBC: MIC ratio >4 (16,17). This definition however is arbitrary with certain bacteriostatic antibiotics being able to kill pathogens at higher concentrations (16,17). Antibiotics including linezolid and vancomycin demonstrate bactericidal activity against some bacteria but bacteriostatic activity against others at higher concentrations (17)(18)(19).…”

“…This definition however is arbitrary with certain bacteriostatic antibiotics being able to kill pathogens at higher concentrations (16,17). Antibiotics including linezolid and vancomycin demonstrate bactericidal activity against some bacteria but bacteriostatic activity against others at higher concentrations (17)(18)(19).…”