■我们的目标是确定在革兰氏阴性细菌(GNB)感染的患者中,与间歇输注(II)相比,延长输注(PI)β-内酰胺类抗生素的结果是否更好。
■我们系统地搜索了PubMed的论文,Cochrane图书馆,Embase,和Clinicaltrials.gov,以死亡率为主要结果,并观察临床治愈率,医院和重症监护病房(ICU)的住院时间,抗生素治疗持续时间,和机械通气(MV)持续时间作为次要结果。
■我们对18项研究的荟萃分析,包括5项随机对照试验和13项观察性研究,共有3035名患者,PI组1,510名,II组1,525名,揭示了重要的发现。PI与死亡率降低相关(RR,0.67;95%CI,0.55-0.81;p=0.001;I2=4.52%)和较短的MV持续时间(SMD,-0.76;95%CI,-1.37至-0.16;p=0.01;I2=87.81%)与II相比。然而,临床治愈率没有差异,抗生素治疗持续时间,住院时间,或ICU停留时间。
与II策略相比,在疑似或确诊的GNB感染患者中使用β-内酰胺抗生素的PI方法可能有利于降低死亡率和MV持续时间。
UNASSIGNED: Our objective is to determine whether prolonged infusion (PI) of beta-lactam antibiotics yields superior outcomes compared to intermittent infusion (II) in patients with Gram-Negative Bacterial (GNB) infections.
UNASSIGNED: We systematically searched papers from PubMed, the Cochrane Library, Embase, and Clinicaltrials.gov, targeting mortality as the primary outcome and looking at the clinical cure rate, hospital and intensive care unit (ICU) stay lengths, antibiotic treatment duration, and mechanical ventilation (MV) duration as secondary outcomes.
UNASSIGNED: Our meta-analysis of 18 studies, including 5 randomized control trials and 13 observational studies, with a total of 3,035 patients-1,510 in the PI group and 1,525 in the II group, revealed significant findings. PI was associated with reduced mortality (RR, 0.67; 95% CI, 0.55-0.81; p = 0.001; I2 = 4.52%) and a shorter MV duration (SMD, -0.76; 95% CI, -1.37 to -0.16; p = 0.01; I2 = 87.81%) compared to II. However, no differences were found in clinical cure rates, antibiotic treatment duration, length of hospital stay, or length of ICU stay.
UNASSIGNED: The PI approach for administering beta-lactam antibiotics in patients with suspected or confirmed GNB infections may be advantageous in reducing mortality rates and the duration of MV when compared to the II strategy.