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Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis
is a multidrug-resistant bacterium that is difficult to treat in hospitals worldwide, leading to high mortality. Published data describing the use of monotherapy or combination therapy and which one is better is still unclear. We aimed to investigate the efficacy of monotherapy and combination thera...
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| Published in: | Antibiotics (Basel) 2022-12, Vol.11 (12), p.1788 |
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| creator | Prawang, Abhisit Chanjamlong, Naphatsawan Rungwara, Woranattha Santimaleeworagun, Wichai Paiboonvong, Taniya Manapattanasatein, Thidarat Pitirattanaworranat, Prompiriya Kitseree, Pongsakorn Kanchanasurakit, Sukrit |
| description | is a multidrug-resistant bacterium that is difficult to treat in hospitals worldwide, leading to high mortality. Published data describing the use of monotherapy or combination therapy and which one is better is still unclear. We aimed to investigate the efficacy of monotherapy and combination therapy in the treatment of
infections. We performed a systematic review of combination therapy and additionally a systematic review and meta-analysis to determine the effects of monotherapy versus combination therapy on mortality in
infections. Electronic databases: Cochrane Library, PubMed, Embase, ClinicalTrials.gov, Scopus, and OpenGrey were accessed. Of the 5030 articles identified, 17 studies were included for a systematic review of combination therapy, of which 4 cohort studies were finally included for meta-analysis. We found there is a trend of favorable outcomes with respect to mortality in the use of combination therapy to treat complex or severe
infections. A meta-analysis of monotherapy showed a statistical significance in the decreasing rate of mortality in hospital-acquired pneumonia (hazard ratio 1.42; 95% confidence interval, 1.04-1.94) compared to combination therapy, but not significant in bacteremia (hazard ratio 0.76; 95% confidence interval, 0.18-3.18). Further studies should continue to explore this association. |
| doi_str_mv | 10.3390/antibiotics11121788 |
| format | article |
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infections. We performed a systematic review of combination therapy and additionally a systematic review and meta-analysis to determine the effects of monotherapy versus combination therapy on mortality in
infections. Electronic databases: Cochrane Library, PubMed, Embase, ClinicalTrials.gov, Scopus, and OpenGrey were accessed. Of the 5030 articles identified, 17 studies were included for a systematic review of combination therapy, of which 4 cohort studies were finally included for meta-analysis. We found there is a trend of favorable outcomes with respect to mortality in the use of combination therapy to treat complex or severe
infections. A meta-analysis of monotherapy showed a statistical significance in the decreasing rate of mortality in hospital-acquired pneumonia (hazard ratio 1.42; 95% confidence interval, 1.04-1.94) compared to combination therapy, but not significant in bacteremia (hazard ratio 0.76; 95% confidence interval, 0.18-3.18). Further studies should continue to explore this association.</description><identifier>ISSN: 2079-6382</identifier><identifier>EISSN: 2079-6382</identifier><identifier>DOI: 10.3390/antibiotics11121788</identifier><identifier>PMID: 36551445</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Antibiotics ; Antimicrobial agents ; Bacteremia ; Bias ; Case reports ; Cohort analysis ; combination therapy ; Infections ; Length of stay ; Meta-analysis ; monotherapy ; Mortality ; Multidrug resistance ; Pneumonia ; Reviews ; Statistical analysis ; Stenotrophomonas maltophilia ; Systematic review ; Therapy ; Ventilators</subject><ispartof>Antibiotics (Basel), 2022-12, Vol.11 (12), p.1788</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c429t-f4f21378a6339f1ac1d5b0e0f6647c9b28d653c5d3dfdb65f8b038c48e332d173</citedby><cites>FETCH-LOGICAL-c429t-f4f21378a6339f1ac1d5b0e0f6647c9b28d653c5d3dfdb65f8b038c48e332d173</cites><orcidid>0000-0002-1268-2665 ; 0000-0001-9974-957X ; 0000-0002-5809-8886</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2756649678/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2756649678?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36551445$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prawang, Abhisit</creatorcontrib><creatorcontrib>Chanjamlong, Naphatsawan</creatorcontrib><creatorcontrib>Rungwara, Woranattha</creatorcontrib><creatorcontrib>Santimaleeworagun, Wichai</creatorcontrib><creatorcontrib>Paiboonvong, Taniya</creatorcontrib><creatorcontrib>Manapattanasatein, Thidarat</creatorcontrib><creatorcontrib>Pitirattanaworranat, Prompiriya</creatorcontrib><creatorcontrib>Kitseree, Pongsakorn</creatorcontrib><creatorcontrib>Kanchanasurakit, Sukrit</creatorcontrib><title>Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis</title><title>Antibiotics (Basel)</title><addtitle>Antibiotics (Basel)</addtitle><description>is a multidrug-resistant bacterium that is difficult to treat in hospitals worldwide, leading to high mortality. Published data describing the use of monotherapy or combination therapy and which one is better is still unclear. We aimed to investigate the efficacy of monotherapy and combination therapy in the treatment of
infections. We performed a systematic review of combination therapy and additionally a systematic review and meta-analysis to determine the effects of monotherapy versus combination therapy on mortality in
infections. Electronic databases: Cochrane Library, PubMed, Embase, ClinicalTrials.gov, Scopus, and OpenGrey were accessed. Of the 5030 articles identified, 17 studies were included for a systematic review of combination therapy, of which 4 cohort studies were finally included for meta-analysis. We found there is a trend of favorable outcomes with respect to mortality in the use of combination therapy to treat complex or severe
infections. A meta-analysis of monotherapy showed a statistical significance in the decreasing rate of mortality in hospital-acquired pneumonia (hazard ratio 1.42; 95% confidence interval, 1.04-1.94) compared to combination therapy, but not significant in bacteremia (hazard ratio 0.76; 95% confidence interval, 0.18-3.18). Further studies should continue to explore this association.</description><subject>Antibiotics</subject><subject>Antimicrobial agents</subject><subject>Bacteremia</subject><subject>Bias</subject><subject>Case reports</subject><subject>Cohort analysis</subject><subject>combination therapy</subject><subject>Infections</subject><subject>Length of stay</subject><subject>Meta-analysis</subject><subject>monotherapy</subject><subject>Mortality</subject><subject>Multidrug resistance</subject><subject>Pneumonia</subject><subject>Reviews</subject><subject>Statistical analysis</subject><subject>Stenotrophomonas maltophilia</subject><subject>Systematic review</subject><subject>Therapy</subject><subject>Ventilators</subject><issn>2079-6382</issn><issn>2079-6382</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptks1qGzEQx5fS0gQ3T1Aogl56cSutpJW2h4Ix_TAkFBr3LGa1UiyzK7mS1sGP0LeuErshKdVFM6P__DQzTFW9Jvg9pS3-AD67zoXsdCKE1ERI-aw6r7Fo5w2V9fNH9ll1kdIWl9MSKrF8WZ3RhnPCGD-vfi_D2DkP2QWP1hsTYXdAexPTlNBV8CGfQs6jYqJ1NJBH4zMKFl1nUwQx7DZhDB4SGmHIxXODA7Ty1ug7avqIFuj6kLIZyy8a_TB7Z24R-B5dmQzzhYfhkFx6Vb2wMCRzcbpn1c8vn9fLb_PL719Xy8XlXLO6zXPLbE2okNCUOVgCmvS8wwbbpmFCt10t-4ZTzXva275ruJUdplIzaSiteyLorFoduX2ArdpFN0I8qABO3QdCvFEQS6GDUbzrMBAhgNOGEU473FuGay6AdVhQWlifjqzd1I2m12UwEYYn0Kcv3m3UTdirVghGWlYA706AGH5NJmU1uqTNMIA3YUqqFlwSTERpaVa9_Ue6DVMsw7tXle7bRsiiokeVjiGlaOxDMQSru81R_9mckvXmcR8POX_3hP4BTfbEww</recordid><startdate>20221209</startdate><enddate>20221209</enddate><creator>Prawang, Abhisit</creator><creator>Chanjamlong, Naphatsawan</creator><creator>Rungwara, Woranattha</creator><creator>Santimaleeworagun, Wichai</creator><creator>Paiboonvong, Taniya</creator><creator>Manapattanasatein, Thidarat</creator><creator>Pitirattanaworranat, Prompiriya</creator><creator>Kitseree, Pongsakorn</creator><creator>Kanchanasurakit, Sukrit</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T7</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-1268-2665</orcidid><orcidid>https://orcid.org/0000-0001-9974-957X</orcidid><orcidid>https://orcid.org/0000-0002-5809-8886</orcidid></search><sort><creationdate>20221209</creationdate><title>Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis</title><author>Prawang, Abhisit ; 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Published data describing the use of monotherapy or combination therapy and which one is better is still unclear. We aimed to investigate the efficacy of monotherapy and combination therapy in the treatment of
infections. We performed a systematic review of combination therapy and additionally a systematic review and meta-analysis to determine the effects of monotherapy versus combination therapy on mortality in
infections. Electronic databases: Cochrane Library, PubMed, Embase, ClinicalTrials.gov, Scopus, and OpenGrey were accessed. Of the 5030 articles identified, 17 studies were included for a systematic review of combination therapy, of which 4 cohort studies were finally included for meta-analysis. We found there is a trend of favorable outcomes with respect to mortality in the use of combination therapy to treat complex or severe
infections. A meta-analysis of monotherapy showed a statistical significance in the decreasing rate of mortality in hospital-acquired pneumonia (hazard ratio 1.42; 95% confidence interval, 1.04-1.94) compared to combination therapy, but not significant in bacteremia (hazard ratio 0.76; 95% confidence interval, 0.18-3.18). Further studies should continue to explore this association.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>36551445</pmid><doi>10.3390/antibiotics11121788</doi><orcidid>https://orcid.org/0000-0002-1268-2665</orcidid><orcidid>https://orcid.org/0000-0001-9974-957X</orcidid><orcidid>https://orcid.org/0000-0002-5809-8886</orcidid><oa>free_for_read</oa></addata></record> |
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| source | ProQuest - Publicly Available Content Database; PubMed Central |
| subjects | Antibiotics Antimicrobial agents Bacteremia Bias Case reports Cohort analysis combination therapy Infections Length of stay Meta-analysis monotherapy Mortality Multidrug resistance Pneumonia Reviews Statistical analysis Stenotrophomonas maltophilia Systematic review Therapy Ventilators |
| title | Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis |
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