Impact of attaining aggressive vs. conservative PK/PD target on the clinical efficacy of beta-lactams for the treatment of Gram-negative infections in the critically ill patients: a systematic review and meta-analysis
Pooled result · Clinical cure rateResult — go to the resultOdds ratio 1.69 95% CI 1.15–2.49Authors' conclusion
Attaining aggressive beta-lactams PK/PD targets provided significant clinical benefits in critical patients.
Study context
- Population
- Critically ill patients treated with beta-lactams for Gram-negative infections
- Participants
- 4,833 patients · 21 observational studies
- Comparison
- Attaining aggressive vs conservative beta-lactam PK/PD target
- Aggressiven = 2,193
- Conservativen = 2,640reference
- Outcome
- Clinical cure rate
Methodological detailsrandom-effects model, adjusted odds ratios (ORs), Risk of bias moderate in 19 studies, severe in 2
- Random-effects model
- Adjusted ORs
- Risk of bias moderate in 19 studies, severe in 2
Pooled result
As reported in the abstract
Odds ratio
1.69
95% CI 1.15–2.49
Aggressive vs Conservative
OR 1.69 (95% CI 1.15–2.49)
Further pooled results
| Outcome | OR (95% CI) | |
|---|---|---|
| Beta-lactam resistance development | 0.06 (0.01–0.29) | |
| 0.050.21520Odds ratio (log scale) |
Predictors of failure to attain aggressive PK/PD target
- Male gender, BMI > 30 kg/m², augmented renal clearance and MIC above clinical breakpoint independent predictors of failure; prolonged/continuous infusion protective
Original publication
Impact of attaining aggressive vs. conservative PK/PD target on the clinical efficacy of beta-lactams for the treatment of Gram-negative infections in the critically ill patients: a systematic review and meta-analysis. Crit Care. Published 16 April 2024. doi:10.
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