Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis
<h3>Background</h3><p dir="ltr">We intended to compare the efficacy and safety outcomes of colistin versus tigecycline as monotherapy or combination therapy against multi-drug resistant (MDR) and extensively drug-resistant (XDR) pathogens. </p><h3>Methods</...
محفوظ في:
| المؤلف الرئيسي: | |
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| مؤلفون آخرون: | , |
| منشور في: |
2022
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| الموضوعات: | |
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إضافة وسم
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| _version_ | 1864513547865686016 |
|---|---|
| author | Dina Abushanab (10696501) |
| author2 | Ziad G. Nasr (18112261) Daoud Al-Badriyeh (832403) |
| author2_role | author author |
| author_facet | Dina Abushanab (10696501) Ziad G. Nasr (18112261) Daoud Al-Badriyeh (832403) |
| author_role | author |
| dc.creator.none.fl_str_mv | Dina Abushanab (10696501) Ziad G. Nasr (18112261) Daoud Al-Badriyeh (832403) |
| dc.date.none.fl_str_mv | 2022-11-15T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.3390/antibiotics11111630 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Efficacy_and_Safety_of_Colistin_versus_Tigecycline_for_Multi-Drug-Resistant_and_Extensively_Drug-Resistant_Gram-Negative_Pathogens_A_Meta-Analysis/29098457 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biological sciences Microbiology Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Epidemiology colistin extensively drug-resistant infection multi-drug resistant tigecycline |
| dc.title.none.fl_str_mv | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">We intended to compare the efficacy and safety outcomes of colistin versus tigecycline as monotherapy or combination therapy against multi-drug resistant (MDR) and extensively drug-resistant (XDR) pathogens. </p><h3>Methods</h3><p dir="ltr">A search was conducted in PubMed, Cochrane CENTRAL, EMBASE, and in the grey literature (i.e., ClinicalTrials.gov and Google Scholar) up to May 2021. Outcomes were clinical response, mortality, infection recurrence, and renal and hepatic toxicity. We pooled odd ratios (OR) using heterogeneity-guided random or fixed models at a statistical significance of <i>p</i> < 0.05. </p><h3>Results</h3><p dir="ltr">Fourteen observational studies involving 1163 MDR/XDR pathogens, receiving tigecycline versus colistin monotherapy or combination, were included. Base-case analyses revealed insignificant differences in the clinical response, reinfection, and hepatic impairment. The 30-day mortality was significantly relatively reduced with tigecycline monotherapy (OR = 0.35, 95% CI 0.16–0.75, p = 0.007). The colistin monotherapy significantly relatively reduced in-hospital mortality (OR = 2.27, 95%CI 1.24–4.16, <i>p</i>= 0.008). Renal impairment rates were lower with tigecycline monotherapy or in combination, and were lower with monotherapy versus colistin-tigecycline combination. Low-risk of bias and moderate/high evidence quality were associated with all studies. </p><h3>Conclusions</h3><p dir="ltr">Within the limitations of this study, it can be concluded that there were no statistically significant differences in main efficacy outcomes between colistin and tigecycline monotherapies or combinations against MDR/XDR infections, except for lower rates of 30-day mortality with tigecycline and in-hospital mortality with colistin. Tigecycline was associated with favourable renal toxicity outcomes.</p><h2>Other Information</h2><p dir="ltr">Published in: Antibiotics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3390/antibiotics11111630" target="_blank">https://dx.doi.org/10.3390/antibiotics11111630</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_939253b7d3dc94a50f4a67763ea8788d |
| identifier_str_mv | 10.3390/antibiotics11111630 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/29098457 |
| publishDate | 2022 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-AnalysisDina Abushanab (10696501)Ziad G. Nasr (18112261)Daoud Al-Badriyeh (832403)Biological sciencesMicrobiologyBiomedical and clinical sciencesPharmacology and pharmaceutical sciencesHealth sciencesEpidemiologycolistinextensively drug-resistantinfectionmulti-drug resistanttigecycline<h3>Background</h3><p dir="ltr">We intended to compare the efficacy and safety outcomes of colistin versus tigecycline as monotherapy or combination therapy against multi-drug resistant (MDR) and extensively drug-resistant (XDR) pathogens. </p><h3>Methods</h3><p dir="ltr">A search was conducted in PubMed, Cochrane CENTRAL, EMBASE, and in the grey literature (i.e., ClinicalTrials.gov and Google Scholar) up to May 2021. Outcomes were clinical response, mortality, infection recurrence, and renal and hepatic toxicity. We pooled odd ratios (OR) using heterogeneity-guided random or fixed models at a statistical significance of <i>p</i> < 0.05. </p><h3>Results</h3><p dir="ltr">Fourteen observational studies involving 1163 MDR/XDR pathogens, receiving tigecycline versus colistin monotherapy or combination, were included. Base-case analyses revealed insignificant differences in the clinical response, reinfection, and hepatic impairment. The 30-day mortality was significantly relatively reduced with tigecycline monotherapy (OR = 0.35, 95% CI 0.16–0.75, p = 0.007). The colistin monotherapy significantly relatively reduced in-hospital mortality (OR = 2.27, 95%CI 1.24–4.16, <i>p</i>= 0.008). Renal impairment rates were lower with tigecycline monotherapy or in combination, and were lower with monotherapy versus colistin-tigecycline combination. Low-risk of bias and moderate/high evidence quality were associated with all studies. </p><h3>Conclusions</h3><p dir="ltr">Within the limitations of this study, it can be concluded that there were no statistically significant differences in main efficacy outcomes between colistin and tigecycline monotherapies or combinations against MDR/XDR infections, except for lower rates of 30-day mortality with tigecycline and in-hospital mortality with colistin. Tigecycline was associated with favourable renal toxicity outcomes.</p><h2>Other Information</h2><p dir="ltr">Published in: Antibiotics<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.3390/antibiotics11111630" target="_blank">https://dx.doi.org/10.3390/antibiotics11111630</a></p>2022-11-15T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.3390/antibiotics11111630https://figshare.com/articles/journal_contribution/Efficacy_and_Safety_of_Colistin_versus_Tigecycline_for_Multi-Drug-Resistant_and_Extensively_Drug-Resistant_Gram-Negative_Pathogens_A_Meta-Analysis/29098457CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/290984572022-11-15T09:00:00Z |
| spellingShingle | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis Dina Abushanab (10696501) Biological sciences Microbiology Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Epidemiology colistin extensively drug-resistant infection multi-drug resistant tigecycline |
| status_str | publishedVersion |
| title | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis |
| title_full | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis |
| title_fullStr | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis |
| title_full_unstemmed | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis |
| title_short | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis |
| title_sort | Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens—A Meta-Analysis |
| topic | Biological sciences Microbiology Biomedical and clinical sciences Pharmacology and pharmaceutical sciences Health sciences Epidemiology colistin extensively drug-resistant infection multi-drug resistant tigecycline |