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Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis

Stenotrophomonas maltophilia 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 mono...

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Autores principales: Prawang, Abhisit, Chanjamlong, Naphatsawan, Rungwara, Woranattha, Santimaleeworagun, Wichai, Paiboonvong, Taniya, Manapattanasatein, Thidarat, Pitirattanaworranat, Prompiriya, Kitseree, Pongsakorn, Kanchanasurakit, Sukrit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9774194/
https://www.ncbi.nlm.nih.gov/pubmed/36551445
http://dx.doi.org/10.3390/antibiotics11121788
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author Prawang, Abhisit
Chanjamlong, Naphatsawan
Rungwara, Woranattha
Santimaleeworagun, Wichai
Paiboonvong, Taniya
Manapattanasatein, Thidarat
Pitirattanaworranat, Prompiriya
Kitseree, Pongsakorn
Kanchanasurakit, Sukrit
author_facet Prawang, Abhisit
Chanjamlong, Naphatsawan
Rungwara, Woranattha
Santimaleeworagun, Wichai
Paiboonvong, Taniya
Manapattanasatein, Thidarat
Pitirattanaworranat, Prompiriya
Kitseree, Pongsakorn
Kanchanasurakit, Sukrit
author_sort Prawang, Abhisit
collection PubMed
description Stenotrophomonas maltophilia 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 S. maltophilia 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 S. maltophilia 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 S. maltopholia 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.
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spelling pubmed-97741942022-12-23 Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis Prawang, Abhisit Chanjamlong, Naphatsawan Rungwara, Woranattha Santimaleeworagun, Wichai Paiboonvong, Taniya Manapattanasatein, Thidarat Pitirattanaworranat, Prompiriya Kitseree, Pongsakorn Kanchanasurakit, Sukrit Antibiotics (Basel) Article Stenotrophomonas maltophilia 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 S. maltophilia 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 S. maltophilia 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 S. maltopholia 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. MDPI 2022-12-09 /pmc/articles/PMC9774194/ /pubmed/36551445 http://dx.doi.org/10.3390/antibiotics11121788 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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/).
spellingShingle Article
Prawang, Abhisit
Chanjamlong, Naphatsawan
Rungwara, Woranattha
Santimaleeworagun, Wichai
Paiboonvong, Taniya
Manapattanasatein, Thidarat
Pitirattanaworranat, Prompiriya
Kitseree, Pongsakorn
Kanchanasurakit, Sukrit
Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis
title Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis
title_full Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis
title_fullStr Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis
title_full_unstemmed Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis
title_short Combination Therapy versus Monotherapy in the Treatment of Stenotrophomonas maltophilia Infections: A Systematic Review and Meta-Analysis
title_sort combination therapy versus monotherapy in the treatment of stenotrophomonas maltophilia infections: a systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9774194/
https://www.ncbi.nlm.nih.gov/pubmed/36551445
http://dx.doi.org/10.3390/antibiotics11121788
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