| Autor: |
Zha L; Department of Respiratory Medicine, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241000, China.; Institute of Infection and Global Health, University of Liverpool, Liverpool L69 7BE, UK., Zhang X; Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, China., Cheng Y; Department of Respiratory Medicine, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241000, China., Xu Q; Department of Critical Care Medicine, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241000, China., Liu L; Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, China., Chen S; Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, China., Lu Z; Department of Respiratory Medicine, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu 241000, China., Guo J; Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, China., Tefsen B; Division of Microbiology, Department of Biology, Utrecht University, 3584 CH Utrecht, The Netherlands.; Natural Sciences, Ronin Institute, Montclair, NJ 07043, USA. |
| Abstrakt: |
Although the combination of polymyxin and tigecycline is widely used in treating carbapenem-resistant bacterial infections, the benefit of this combination is still uncertain. To assess whether adding polymyxin B to the high-dose tigecycline regimen would result in better clinical outcomes than the high-dose tigecycline therapy in patients with pneumonia caused by carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii , we conducted a propensity score-matched cohort study in a single center between July 2019 and December 2021. Of the 162 eligible patients, 102 were included in the 1:1 matched cohort. The overall 14-day mortality in the matched cohort was 24.5%. Compared with high-dose tigecycline, the combination therapy was not associated with better clinical outcomes, and showed similar 14-day mortality (OR, 0.72, 95% CI 0.27-1.83, p = 0.486), clinical cure (OR, 1.09, 95% CI 0.48-2.54, p = 0.823), microbiological cure (OR, 0.96, 95% CI 0.39-2.53, p = 0.928) and rate of nephrotoxicity (OR 0.85, 95% CI 0.36-1.99, p = 0.712). Subgroup analyses also did not demonstrate any statistical differences. Based on these results, it is reasonable to recommend against adding polymyxin B to the high-dose tigecycline regimen in treating pneumonia caused by carbapenem-resistant K. pneumoniae and A. baumannii . |
