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学科主题: 临床医学
题名:
Clinical Outcomes with Alternative Dosing Strategies for Piperacillin/Tazobactam: A Systematic Review and Meta-Analysis
作者: Yang, Hui1,2; Zhang, Chao1; Zhou, Quanyu3; Wang, Yike2; Chen, Lujia2
刊名: PLOS ONE
发表日期: 2015-01-09
DOI: 10.1371/journal.pone.0116769
卷: 10, 期:1
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Multidisciplinary Sciences
研究领域[WOS]: Science & Technology - Other Topics
关键词[WOS]: COMPLICATED INTRAABDOMINAL INFECTION ; CRITICALLY-ILL PATIENTS ; EXTENDED-INFUSION PIPERACILLIN/TAZOBACTAM ; BETA-LACTAM ANTIBIOTICS ; RANDOM-EFFECTS MODELS ; PSEUDOMONAS-AERUGINOSA ; ANTIMICROBIAL RESISTANCE ; INTERMITTENT INFUSION ; TAZOBACTAM ; PHARMACOKINETICS
英文摘要:

Objectives A better dosing strategy can improve clinical outcomes for patients. We sought to compare the extended or continuous infusion with conventional intermittent infusion of piperacillin/ tazobactam, investigating which approach is better and worthy of recommendation for clinical use.

Methods Articles were gathered from PubMed, Web of Science, ProQuest, Science Direct, Cochrane, two Chinese literature databases (CNKI, Wan Fang Data) and related ICAAC and ACCP conferences. Randomized controlled and observational studies that compared extended or continuous infusion with conventional intermittent infusion of piperacillin/ tazobactam were identified from the databases above and analyzed. Two reviewers independently extracted and investigated the data. A meta-analysis was performed using Revman 5.2 software. The quality of each study was assessed. Sensitivity analysis and publication bias were evaluated.

Results Five randomized controlled trials and nine observational studies were included in this study. All included studies had high quality and no publication bias was found. Compared to the conventional intermittent infusion approach, the extended or continuous infusion group had a significantly higher clinical cure rate (OR 1.88, 95% CI 1.29-2.73, P = 0.0009) and a lower mortality rate (OR 0.67, 95% CI 0.50-0.89, P = 0.005). No statistical difference was observed for bacteriologic cure (OR 1.40, 95% CI 0.82-2.37, P = 0.22) between the two dosing regimens. The sensitivity analysis showed the results were stable.

Conclusions Our systematic review and meta-analysis suggested that the extended or continuous infusion strategy of piperacillin/tazobactam should be recommended for clinical use considering its higher clinical cure rate and lower mortality rate in comparison with conventional intermittent strategy. Data from this study could be extrapolated for other beta-lactam antimicrobials. Therefore, this dosing strategy could be considered in clinical practice.

语种: 英语
项目资助者: Peking University Third Hospital research
WOS记录号: WOS:000348168100008
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55210
Appears in Collections:北京大学第三临床医学院_药剂科_期刊论文

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作者单位: 1.Peking Univ, Dept Pharm, Hosp 3, Beijing 100871, Peoples R China
2.First Peoples Hosp, Dept Pharm, Lianyungang, Jiangsu, Peoples R China
3.Peking Univ, Sch Pharmaceut Sci, Beijing 100871, Peoples R China

Recommended Citation:
Yang, Hui,Zhang, Chao,Zhou, Quanyu,et al. Clinical Outcomes with Alternative Dosing Strategies for Piperacillin/Tazobactam: A Systematic Review and Meta-Analysis[J]. PLOS ONE,2015,10(1).
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