Piperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review
| Autor: | Jakob Steen Andersen, Morten Hylander Møller, Niels Frimodt-Møller, Michael Patrick Achiam, Fredrik Sjövall, Marie Warrer Petersen, Andreas Bender Jonsson, Anders Perner, Morten Steensen |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Secondary infection Drug resistance Tazobactam 03 medical and health sciences 0302 clinical medicine Internal medicine Drug Resistance Multiple Bacterial polycyclic compounds Medicine Humans 030212 general & internal medicine Adverse effect business.industry 030208 emergency & critical care medicine General Medicine Bacterial Infections biochemical phenomena metabolism and nutrition Anti-Bacterial Agents Clinical trial Anesthesiology and Pain Medicine Piperacillin Tazobactam Drug Combination Carbapenems Meta-analysis Piperacillin/tazobactam business medicine.drug Piperacillin |
| Zdroj: | Acta anaesthesiologica Scandinavica. 63(7) |
| ISSN: | 1399-6576 |
| Popis: | INTRODUCTION: Early empirical broad-spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β-lactam/β-lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem-sparing agent to reduce the incidence of multidrug-resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species. Whether these findings also apply to empirical piperacillin/tazobactam in patients with other severe infections, including sepsis, is unknown. We aim to assess the benefits and harms of empirical and definitive piperacillin/tazobactam vs carbapenems for patients with severe bacterial infections.METHODS AND ANALYSIS: This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement, the Cochrane Handbook and the Grading of Recommendations, Assessment, Development, and Evaluation approach. We will include randomised clinical trials assessing piperacillin/tazobactam vs carbapenems in patients with severe bacterial infections of any origin. The primary outcome will be all-cause short-term mortality ≤ 90 days. Secondary outcomes will include all-cause long-term mortality > 90 days, adverse events, quality of life, use of life support, secondary infections, antibiotic resistance, and length of stay. We will conduct meta-analyses, including pre-planned subgroup and sensitivity analyses for all assessed outcomes. The risk of random errors in the meta-analyses will be assessed by trial sequential analysis. (Less) |
| Databáze: | OpenAIRE |
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