已发表论文

以美罗培南为基础的组合在鲍曼不动杆菌感染治疗中的协同作用:系统综述和荟萃分析

 

Authors Jiang Z, He X, Li J

Received 24 April 2018

Accepted for publication 13 June 2018

Published 7 August 2018 Volume 2018:11 Pages 1083—1095

DOI https://doi.org/10.2147/IDR.S172137

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 3

Editor who approved publication: Professor Suresh Antony

Purpose: The main objective of our meta-analysis was to examine the in vitro synergistic effect of meropenem-based combination therapies against Acinetobacter baumannii  through a systematic review of the existing literature. 
Methods: An extensive search was performed with no restrictions on date of publication, language, and publication type. Our study evaluated the main conclusions drawn from various studies describing the synergistic activity of combination therapies in vitro. 
Results: In this review, 56 published studies were included. Our report included data on 20 types of antibiotics combined with meropenem in 1,228 Acinetobacter baumannii  isolates. In time-kill studies, meropenem combined with polymyxin B and rifampicin showed synergy rates of 98.3% (95% CI, 83.7%–100.0%) and 89.4% (95% CI, 57.2%–100.0%), respectively, for Acinetobacter baumannii , modest synergy rates were found for meropenem combined with several antibiotics such as colistin and sulbactam, and no synergy effect was displayed in the combination of meropenem and ciprofloxacin, whereas in checkerboard method, the synergy rates of polymyxin B and rifampicin were 37.0% (95% CI, 0.00%–100.0%) and 56.3% (95% CI, 8.7%–97.8%), respectively. 
Conclusion: We found that time-kill studies generally identified the greatest synergy, while checkerboard and Etest methods yielded relatively poor synergy rates. Further well-designed in vivo studies should be carried out to confirm these findings.
Keywords: Acinetobacter baumannii , meropenem, synergy, combination, in vitro




Figure 6 Forest plot and pooled synergy rates for meropenem–polymyxin B combinations in checkerboard method.