Efficacy and safety of antibiotics targeting Gram-negative bacteria in nosocomial pneumonia: a systematic review and Bayesian network meta-analysis
Pooled result · 28 day mortalityResult — go to the resultOdds ratio 0.43 95% CrI 0.17–0.94Authors' conclusion
This network meta-analysis suggests that most antibiotic regimens, including new combinations and cefiderocol, have similar efficacy and safety in treating susceptible Gram-negative bacilli in NP.
Study context
- Population
- Patients with nosocomial pneumonia (NP) treated with antibiotics targeting Gram-negative bacilli
- Participants
- 4,993 patients · 16 studies
- Comparison
- 13 antibiotic regimens targeting Gram-negative bacilli compared with each other
- Outcome
- Mortality
- Follow-up
- 28 day
Pooled result
28 day mortality
Odds ratio
0.43
95% CrI 0.17–0.94
Meropenem plus aerosolized colistin vs Intravenous colistin
OR 0.43 (95% CrI 0.17–0.94)
As reported in the abstract
Further pooled results
| Outcome | OR (95% CrI) | |
|---|---|---|
| Clinical failure: ceftazidime vs comparatorsCeftazidime vs Meropenem plus aerosolized colistin · CrI | 1.97 (1.19–3.45) | |
| Clinical failure: ceftazidime vs comparatorsCeftazidime vs Meropenem · CrI | 1.40 (1.00–2.01) | |
| Clinical failure: ceftazidime vs comparatorsCeftazidime vs Imipemen/cilastatin/relebactam · CrI | 1.74 (1.03–2.90) | |
| Clinical failure: ceftazidime vs comparatorsCeftazidime vs Ceftazidime/avibactam · CrI | 1.48 (1.02–2.20) | |
| 0.20.5125Odds ratio (log scale) |
Microbiological cure
- No substantial difference between regimens; ceftolozane/tazobactam had the highest probability of being superior
Safety
- No significant difference between treatments for adverse events
- Acute kidney failure more common with intravenous colistin
Original publication
Efficacy and safety of antibiotics targeting Gram-negative bacteria in nosocomial pneumonia: a systematic review and Bayesian network meta-analysis. Ann Intensive Care. Published 25 April 2024. doi:10.
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