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Beta lactam antibiotic monotherapy versus beta lactam-aminoglycoside antibiotic combination therapy for sepsis

  1. Mical Paul1,*,
  2. Simona Grozinsky-Glasberg2,
  3. Karla Soares-Weiser3,
  4. Leonard Leibovici4

Editorial Group: Cochrane Anaesthesia Group

Published Online: 25 JAN 2006

Assessed as up-to-date: 11 NOV 2005

DOI: 10.1002/14651858.CD003344.pub2


How to Cite

Paul M, Grozinsky-Glasberg S, Soares-Weiser K, Leibovici L. Beta lactam antibiotic monotherapy versus beta lactam-aminoglycoside antibiotic combination therapy for sepsis. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD003344. DOI: 10.1002/14651858.CD003344.pub2.

Author Information

  1. 1

    Rambam Health Care Center. Haifa, Israel and Sackler Faculty of Medicine, Unit of Infectious Diseases, Tel Aviv, Israel

  2. 2

    Dept of Medicine, Hadassah-Hebrew University Medical Center, Neuroendocrine Tumors Unit, Endocrinology & Metabolism Service, Jerusalem, Israel

  3. 3

    Enhance Reviews Ltd, Wantage, UK

  4. 4

    Beilinson Hospital, Rabin Medical Center, Department of Medicine E, Petah Tikva, Israel

*Mical Paul, Unit of Infectious Diseases, Rambam Health Care Center. Haifa, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 49100, Israel. paulm@post.tau.ac.il. mica@zahav.net.il; MichalP2@clalit.org.il; paulm@post.tau.ac.il.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 25 JAN 2006

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[Figure 1]
Figure 1. Funnel failure.
[Figure 2]
Figure 2. Funnel mortality.

All cause mortality
[Analysis 1.1]
Analysis 1.1. Comparison 1 Monotherapy versus combination therapy, Outcome 1 All cause fatality.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Monotherapy versus combination therapy, Outcome 2 All cause fatality by study groups.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Monotherapy versus combination therapy, Outcome 3 All cause fatality (Gram negative infections).
[Analysis 1.4]
Analysis 1.4. Comparison 1 Monotherapy versus combination therapy, Outcome 4 All cause fatality (Gram negative bacteremia).
[Analysis 1.5]
Analysis 1.5. Comparison 1 Monotherapy versus combination therapy, Outcome 5 All cause fatality (non urinary tract infections).
[Analysis 2.1]
Analysis 2.1. Comparison 2 Monotherapy versus combination therapy, Outcome 1 Clinical failure.
[Analysis 2.2]
Analysis 2.2. Comparison 2 Monotherapy versus combination therapy, Outcome 2 Clinical failure by study groups.
[Analysis 2.3]
Analysis 2.3. Comparison 2 Monotherapy versus combination therapy, Outcome 3 Bacteriological failure - all.
[Analysis 2.4]
Analysis 2.4. Comparison 2 Monotherapy versus combination therapy, Outcome 4 UTI relapse or re-infection.
[Analysis 2.5]
Analysis 2.5. Comparison 2 Monotherapy versus combination therapy, Outcome 5 Clinical failure (Gram negative infections).
[Analysis 2.6]
Analysis 2.6. Comparison 2 Monotherapy versus combination therapy, Outcome 6 Clinical failure (Gram negative bacteremia).
[Analysis 2.7]
Analysis 2.7. Comparison 2 Monotherapy versus combination therapy, Outcome 7 Clinical failure (Pseudomonas aeruginosa infections).
[Analysis 2.8]
Analysis 2.8. Comparison 2 Monotherapy versus combination therapy, Outcome 8 Clinical failure (bacteremia).
[Analysis 2.9]
Analysis 2.9. Comparison 2 Monotherapy versus combination therapy, Outcome 9 Clinical failure (urinary tract infections).
[Analysis 2.10]
Analysis 2.10. Comparison 2 Monotherapy versus combination therapy, Outcome 10 Clinical failure (non urinary tract infections).
[Analysis 3.1]
Analysis 3.1. Comparison 3 Monotherapy versus combination therapy, Outcome 1 Bacterial superinfections.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Monotherapy versus combination therapy, Outcome 2 Fungal superinfections.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Monotherapy versus combination therapy, Outcome 3 Bacterial colonization.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Monotherapy versus combination therapy, Outcome 4 Fungal colonization.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Monotherapy versus combination therapy, Outcome 5 Bacterial colonization - surveillance cultures.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Monotherapy versus combination therapy, Outcome 6 Bacterial resistance development.
[Analysis 4.1]
Analysis 4.1. Comparison 4 Monotherapy versus combination therapy, Outcome 1 Any adverse event.
[Analysis 4.2]
Analysis 4.2. Comparison 4 Monotherapy versus combination therapy, Outcome 2 Adverse events requiring treatment discontinuation.
[Analysis 4.3]
Analysis 4.3. Comparison 4 Monotherapy versus combination therapy, Outcome 3 Any nephrotoxicity.
[Analysis 5.1]
Analysis 5.1. Comparison 5 Monotherapy versus combination therapy, Outcome 1 Drop-outs for all cause fatality.
[Analysis 5.2]
Analysis 5.2. Comparison 5 Monotherapy versus combination therapy, Outcome 2 Drop-outs for clinical failure.
[Analysis 6.1]
Analysis 6.1. Comparison 6 Monotherapy versus combination therapy, Outcome 1 All cause fatality (Gram positive infections).
[Analysis 6.2]
Analysis 6.2. Comparison 6 Monotherapy versus combination therapy, Outcome 2 Clinical failure (Gram positive infections).
[Analysis 6.3]
Analysis 6.3. Comparison 6 Monotherapy versus combination therapy, Outcome 3 Bacteriological failure (Gram positive infections).
[Analysis 6.4]
Analysis 6.4. Comparison 6 Monotherapy versus combination therapy, Outcome 4 Need for operation (endocarditis).
[Analysis 7.1]
Analysis 7.1. Comparison 7 Monotherapy versus combination therapy (sensitivity analyses), Outcome 1 All cause fatality by allocation concealment.
[Analysis 7.2]
Analysis 7.2. Comparison 7 Monotherapy versus combination therapy (sensitivity analyses), Outcome 2 All cause fatality by allocation generation.
[Analysis 7.3]
Analysis 7.3. Comparison 7 Monotherapy versus combination therapy (sensitivity analyses), Outcome 3 All cause fatality by ITT vs. per-protocol analysis.
[Analysis 7.4]
Analysis 7.4. Comparison 7 Monotherapy versus combination therapy (sensitivity analyses), Outcome 4 Clinical failure by allocation concealment.
[Analysis 7.5]
Analysis 7.5. Comparison 7 Monotherapy versus combination therapy (sensitivity analyses), Outcome 5 Clinical failure by allocation generation.
[Analysis 7.6]
Analysis 7.6. Comparison 7 Monotherapy versus combination therapy (sensitivity analyses), Outcome 6 Clinical failure by blinding.
[Analysis 7.7]
Analysis 7.7. Comparison 7 Monotherapy versus combination therapy (sensitivity analyses), Outcome 7 Clinical failure by ITT versus per-protocol analysis.