| Title |
Combination antibiotic treatment versus monotherapy for multidrug-resistant, extensively drug-resistant, and pandrug-resistant Acinetobacter infections: a systematic review
|
|---|---|
| Published in |
European Journal of Clinical Microbiology & Infectious Diseases, May 2014
|
| DOI | 10.1007/s10096-014-2124-9 |
| Pubmed ID | |
| Authors |
P. Poulikakos, G. S. Tansarli, M. E. Falagas |
| Abstract |
Controversy surrounds combination treatment or monotherapy against multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) Acinetobacter infections in clinical practice. We searched the PubMed and Scopus databases for studies reporting on the clinical outcomes of patients infected with MDR, XDR, and PDR Acinetobacter spp. with regard to the administered intravenous antibiotic treatment. Twelve studies reporting on 1,040 patients suffering from 1,044 infectious episodes of MDR Acinetobacter spp. were included. The overall mortality between studies varied from 28.6 to 70 %; from 25 to 100 % in the monotherapy arm and from 27 to 57.1 % in the combination arm. Combination treatment was superior to monotherapy in three studies, where carbapenem with ampicillin/sulbactam (mortality 30.8 %, p = 0.012), carbapenem with colistin (mortality 23 %, p = 0.009), and combinations of colistin with rifampicin, sulbactam with aminoglycosides, tigecycline with colistin and rifampicin, and tigecycline with rifampicin and amikacin (mortality 27 %, p < 0.05) were used against MDR Acinetobacter spp. resistant at least to carbapenems. The benefit was not validated in the remaining studies. Clinical success varied from 42.4 to 76.9 % and microbiological eradication varied from 32.7 to 67.3 %. Adverse events referred mainly to polymixins nephrotoxicity that varied from 19 to 50 %. The emergence of resistance was noted with tigecycline regimens in off-label uses in three studies. The available data preclude a firm recommendation with regard to combination treatment or monotherapy. For the time being, combination treatment may be preferred for severely ill patients. We urge for randomized controlled trials examining the optimal treatment of infections due to MDR, XDR, and PDR Acinetobacter spp. |
X Demographics
The data shown below were collected from the profiles of 11 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 4 | 36% |
| Unknown | 7 | 64% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 55% |
| Practitioners (doctors, other healthcare professionals) | 3 | 27% |
| Scientists | 2 | 18% |
Mendeley readers
The data shown below were compiled from readership statistics for 128 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 1 | <1% |
| United States | 1 | <1% |
| Estonia | 1 | <1% |
| Germany | 1 | <1% |
| Unknown | 124 | 97% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 24 | 19% |
| Student > Ph. D. Student | 16 | 13% |
| Student > Master | 16 | 13% |
| Student > Bachelor | 12 | 9% |
| Student > Postgraduate | 12 | 9% |
| Other | 25 | 20% |
| Unknown | 23 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 32 | 25% |
| Agricultural and Biological Sciences | 19 | 15% |
| Immunology and Microbiology | 12 | 9% |
| Biochemistry, Genetics and Molecular Biology | 10 | 8% |
| Pharmacology, Toxicology and Pharmaceutical Science | 8 | 6% |
| Other | 16 | 13% |
| Unknown | 31 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 September 2021.
All research outputs
#3,621,480
of 24,761,242 outputs
Outputs from European Journal of Clinical Microbiology & Infectious Diseases
#284
of 2,933 outputs
Outputs of similar age
#34,640
of 232,528 outputs
Outputs of similar age from European Journal of Clinical Microbiology & Infectious Diseases
#6
of 56 outputs
Altmetric has tracked 24,761,242 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,933 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.8. This one has done particularly well, scoring higher than 90% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 232,528 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 84% of its contemporaries.
We're also able to compare this research output to 56 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 91% of its contemporaries.