| Carbapenems for the treatment of immunocompetent adult patients with nosocomial pneumonia. | |
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MedLine Citation:
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PMID: 17329491 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The comparative effectiveness and safety of carbapenems with other beta-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 beta-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 beta-lactams, alone or in combination with aminoglycosides, for the empirical treatment of immunocompetent adult patients with hospital-acquired 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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Authors:
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I I Siempos; K Z Vardakas; K G Manta; M E Falagas |
Publication Detail:
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Type: Comparative Study; Journal Article; Meta-Analysis |
Journal Detail:
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Title: The European respiratory journal Volume: 29 ISSN: 0903-1936 ISO Abbreviation: Eur. Respir. J. Publication Date: 2007 Mar |
Date Detail:
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Created Date: 2007-03-01 Completed Date: 2007-05-16 Revised Date: 2013-05-23 |
Medline Journal Info:
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Nlm Unique ID: 8803460 Medline TA: Eur Respir J Country: Switzerland |
Other Details:
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Languages: eng Pagination: 548-60 Citation Subset: IM |
Affiliation:
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Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acinetobacter Infections
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drug therapy,
immunology,
mortality Acinetobacter baumannii Adult Aminoglycosides / adverse effects, therapeutic use Carbapenems / adverse effects, therapeutic use* Cross Infection / drug therapy*, immunology, mortality Drug Resistance, Multiple Drug Therapy, Combination Fluoroquinolones / adverse effects, therapeutic use Humans Immunocompetence / immunology Intensive Care Units Pneumonia, Bacterial / drug therapy*, immunology, mortality Pseudomonas Infections / drug therapy, immunology, mortality Randomized Controlled Trials as Topic Respiration, Artificial Survival Rate Thienamycins / adverse effects, therapeutic use Treatment Outcome beta-Lactams / adverse effects, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Aminoglycosides; 0/Carbapenems; 0/Fluoroquinolones; 0/Thienamycins; 0/beta-Lactams; 96036-03-2/meropenem |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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