Clinical outcomes of prolonged infusion (extended infusion or continuous infusion) versus intermittent bolus of meropenem in severe infection: A meta-analysis
Meropenem exhibits time-dependent antimicrobial activity and prolonged infusion (PI) (extended infusion or continuous infusion, EI or CI) of meropenem can better achieve pharmacodynamics target when comparing with intermittent bolus (IB). However, the clinical outcomes between two groups remain inco...
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| Veröffentlicht in: | PloS one 2018-07, Vol.13 (7), p.e0201667-e0201667 |
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| creator | Yu, Zhenwei Pang, Xiaoping Wu, Xuqi Shan, Chunlei Jiang, Saiping |
| description | Meropenem exhibits time-dependent antimicrobial activity and prolonged infusion (PI) (extended infusion or continuous infusion, EI or CI) of meropenem can better achieve pharmacodynamics target when comparing with intermittent bolus (IB). However, the clinical outcomes between two groups remain inconclusive.
To evaluate current published literatures by meta-analysis to ascertain whether PI of meropenem can improve clinical outcomes.
Medline, Cochrane database and EMBASE were searched. Randomized control trails (RCT) and observational studies which compared the clinical outcomes of PI and IB groups were included and evaluated for quality. The data of studies were extracted and meta-analysis was performed using Revman 5.3 software.
Six RCTs and 4 observation studies with relatively high quality were included in this analysis. Compared to IB group, PI group had a higher clinical success rate (odd ratio 2.10, 95% confidence interval 1.31-3.38) and a lower mortality (risk ratio 0.66, 95% confidence interval 0.50-0.88). The sensitivity analysis showed the results were stable.
PI of meropenem was associated with a higher clinical improvement rate and a lower mortality. It is recommended for patients with severe infection or infected by less sensitive microbial. |
| doi_str_mv | 10.1371/journal.pone.0201667 |
| format | Article |
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To evaluate current published literatures by meta-analysis to ascertain whether PI of meropenem can improve clinical outcomes.
Medline, Cochrane database and EMBASE were searched. Randomized control trails (RCT) and observational studies which compared the clinical outcomes of PI and IB groups were included and evaluated for quality. The data of studies were extracted and meta-analysis was performed using Revman 5.3 software.
Six RCTs and 4 observation studies with relatively high quality were included in this analysis. Compared to IB group, PI group had a higher clinical success rate (odd ratio 2.10, 95% confidence interval 1.31-3.38) and a lower mortality (risk ratio 0.66, 95% confidence interval 0.50-0.88). The sensitivity analysis showed the results were stable.
PI of meropenem was associated with a higher clinical improvement rate and a lower mortality. It is recommended for patients with severe infection or infected by less sensitive microbial.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0201667</identifier><identifier>PMID: 30059536</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Antibiotics ; Antimicrobial activity ; Antimicrobial agents ; Biology and Life Sciences ; Clinical outcomes ; Clinical trials ; Confidence intervals ; Dosage and administration ; Drug dosages ; Drug therapy ; Infections ; Medical ethics ; Medicine and Health Sciences ; Meropenem ; Meta-analysis ; Microorganisms ; Mortality ; Observational studies ; Pathogens ; Pharmacodynamics ; Pharmacology ; Physical Sciences ; Pneumonia ; Research and Analysis Methods ; Science Policy ; Sensitivity analysis ; Sepsis ; Studies ; Systematic review ; Time dependence ; Treatment outcome ; Ventilators</subject><ispartof>PloS one, 2018-07, Vol.13 (7), p.e0201667-e0201667</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Yu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Yu et al 2018 Yu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c659t-229e3ffec0b04684427d6f7685124cd9ad340ee1ba60ac164deb37fed38ee4a73</citedby><cites>FETCH-LOGICAL-c659t-229e3ffec0b04684427d6f7685124cd9ad340ee1ba60ac164deb37fed38ee4a73</cites><orcidid>0000-0002-3776-2290</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066326/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6066326/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30059536$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yu, Zhenwei</creatorcontrib><creatorcontrib>Pang, Xiaoping</creatorcontrib><creatorcontrib>Wu, Xuqi</creatorcontrib><creatorcontrib>Shan, Chunlei</creatorcontrib><creatorcontrib>Jiang, Saiping</creatorcontrib><title>Clinical outcomes of prolonged infusion (extended infusion or continuous infusion) versus intermittent bolus of meropenem in severe infection: A meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Meropenem exhibits time-dependent antimicrobial activity and prolonged infusion (PI) (extended infusion or continuous infusion, EI or CI) of meropenem can better achieve pharmacodynamics target when comparing with intermittent bolus (IB). However, the clinical outcomes between two groups remain inconclusive.
To evaluate current published literatures by meta-analysis to ascertain whether PI of meropenem can improve clinical outcomes.
Medline, Cochrane database and EMBASE were searched. Randomized control trails (RCT) and observational studies which compared the clinical outcomes of PI and IB groups were included and evaluated for quality. The data of studies were extracted and meta-analysis was performed using Revman 5.3 software.
Six RCTs and 4 observation studies with relatively high quality were included in this analysis. Compared to IB group, PI group had a higher clinical success rate (odd ratio 2.10, 95% confidence interval 1.31-3.38) and a lower mortality (risk ratio 0.66, 95% confidence interval 0.50-0.88). The sensitivity analysis showed the results were stable.
PI of meropenem was associated with a higher clinical improvement rate and a lower mortality. It is recommended for patients with severe infection or infected by less sensitive microbial.</description><subject>Analysis</subject><subject>Antibiotics</subject><subject>Antimicrobial activity</subject><subject>Antimicrobial agents</subject><subject>Biology and Life Sciences</subject><subject>Clinical outcomes</subject><subject>Clinical trials</subject><subject>Confidence intervals</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>Drug therapy</subject><subject>Infections</subject><subject>Medical ethics</subject><subject>Medicine and Health Sciences</subject><subject>Meropenem</subject><subject>Meta-analysis</subject><subject>Microorganisms</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Pathogens</subject><subject>Pharmacodynamics</subject><subject>Pharmacology</subject><subject>Physical Sciences</subject><subject>Pneumonia</subject><subject>Research and Analysis Methods</subject><subject>Science Policy</subject><subject>Sensitivity analysis</subject><subject>Sepsis</subject><subject>Studies</subject><subject>Systematic review</subject><subject>Time dependence</subject><subject>Treatment 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Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yu, Zhenwei</au><au>Pang, Xiaoping</au><au>Wu, Xuqi</au><au>Shan, Chunlei</au><au>Jiang, Saiping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes of prolonged infusion (extended infusion or continuous infusion) versus intermittent bolus of meropenem in severe infection: A meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-07-30</date><risdate>2018</risdate><volume>13</volume><issue>7</issue><spage>e0201667</spage><epage>e0201667</epage><pages>e0201667-e0201667</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Meropenem exhibits time-dependent antimicrobial activity and prolonged infusion (PI) (extended infusion or continuous infusion, EI or CI) of meropenem can better achieve pharmacodynamics target when comparing with intermittent bolus (IB). However, the clinical outcomes between two groups remain inconclusive.
To evaluate current published literatures by meta-analysis to ascertain whether PI of meropenem can improve clinical outcomes.
Medline, Cochrane database and EMBASE were searched. Randomized control trails (RCT) and observational studies which compared the clinical outcomes of PI and IB groups were included and evaluated for quality. The data of studies were extracted and meta-analysis was performed using Revman 5.3 software.
Six RCTs and 4 observation studies with relatively high quality were included in this analysis. Compared to IB group, PI group had a higher clinical success rate (odd ratio 2.10, 95% confidence interval 1.31-3.38) and a lower mortality (risk ratio 0.66, 95% confidence interval 0.50-0.88). The sensitivity analysis showed the results were stable.
PI of meropenem was associated with a higher clinical improvement rate and a lower mortality. It is recommended for patients with severe infection or infected by less sensitive microbial.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30059536</pmid><doi>10.1371/journal.pone.0201667</doi><orcidid>https://orcid.org/0000-0002-3776-2290</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Antibiotics Antimicrobial activity Antimicrobial agents Biology and Life Sciences Clinical outcomes Clinical trials Confidence intervals Dosage and administration Drug dosages Drug therapy Infections Medical ethics Medicine and Health Sciences Meropenem Meta-analysis Microorganisms Mortality Observational studies Pathogens Pharmacodynamics Pharmacology Physical Sciences Pneumonia Research and Analysis Methods Science Policy Sensitivity analysis Sepsis Studies Systematic review Time dependence Treatment outcome Ventilators |
| title | Clinical outcomes of prolonged infusion (extended infusion or continuous infusion) versus intermittent bolus of meropenem in severe infection: A meta-analysis |
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