Intervention Review

You have free access to this content

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

  1. Mical Paul1,*,
  2. Adi Lador2,
  3. Simona Grozinsky-Glasberg3,
  4. Leonard Leibovici2

Editorial Group: Cochrane Anaesthesia Group

Published Online: 7 JAN 2014

Assessed as up-to-date: 4 NOV 2013

DOI: 10.1002/14651858.CD003344.pub3


How to Cite

Paul M, Lador A, Grozinsky-Glasberg S, Leibovici L. Beta lactam antibiotic monotherapy versus beta lactam-aminoglycoside antibiotic combination therapy for sepsis. Cochrane Database of Systematic Reviews 2014, Issue 1. Art. No.: CD003344. DOI: 10.1002/14651858.CD003344.pub3.

Author Information

  1. 1

    Rambam Health Care Campus and the Technion-Israel Institute of Technology, Division of Infectious Diseases, Haifa, Israel

  2. 2

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

  3. 3

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

*Mical Paul, Division of Infectious Diseases, Rambam Health Care Campus and the Technion-Israel Institute of Technology, 6 Ha'Aliya Street, Haifa, 31096, Israel. paulm@post.tau.ac.il. mica@zahav.net.il; MichalP2@clalit.org.il; paulm@post.tau.ac.il.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 7 JAN 2014

SEARCH

[Figure 1]
Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 3]
Figure 3. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 4]
Figure 4. Funnel mortality.

All-cause mortality.
[Figure 5]
Figure 5. Funnel failure.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Monotherapy versus combination therapy, Outcome 1 All-cause mortality.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Monotherapy versus combination therapy, Outcome 2 All-cause mortality by study groups.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Monotherapy versus combination therapy, Outcome 3 Clinical failure.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Monotherapy versus combination therapy, Outcome 4 Clinical failure by study groups.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Monotherapy versus combination therapy, Outcome 5 UTI relapse or reinfection.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Monotherapy versus combination therapy, Outcome 6 Bacteriological failure—all.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Monotherapy versus combination therapy, Outcome 7 Bacterial superinfection.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Monotherapy versus combination therapy, Outcome 8 Fungal superinfection.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Monotherapy versus combination therapy, Outcome 9 Bacterial colonization.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Monotherapy versus combination therapy, Outcome 10 Bacterial colonization—surveillance cultures.
[Analysis 1.11]
Analysis 1.11. Comparison 1 Monotherapy versus combination therapy, Outcome 11 Development of bacterial resistance.
[Analysis 1.12]
Analysis 1.12. Comparison 1 Monotherapy versus combination therapy, Outcome 12 Any adverse event.
[Analysis 1.13]
Analysis 1.13. Comparison 1 Monotherapy versus combination therapy, Outcome 13 Adverse events requiring treatment discontinuation.
[Analysis 1.14]
Analysis 1.14. Comparison 1 Monotherapy versus combination therapy, Outcome 14 Any nephrotoxicity.
[Analysis 2.1]
Analysis 2.1. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 1 All-cause mortality (Gram-negative infection).
[Analysis 2.2]
Analysis 2.2. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 2 All-cause mortality (Gram-negative bacteraemia).
[Analysis 2.3]
Analysis 2.3. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 3 All-cause mortality (non–urinary tract infection).
[Analysis 2.4]
Analysis 2.4. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 4 All-cause mortality (Gram-positive infection).
[Analysis 2.5]
Analysis 2.5. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 5 Clinical failure (Gram-negative infection).
[Analysis 2.6]
Analysis 2.6. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 6 Clinical failure (Pseudomonas aeruginosa infection).
[Analysis 2.7]
Analysis 2.7. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 7 Clinical failure (Gram-negative bacteraemia).
[Analysis 2.8]
Analysis 2.8. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 8 Clinical failure (bacteraemia).
[Analysis 2.9]
Analysis 2.9. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 9 Clinical failure (urinary tract infection).
[Analysis 2.10]
Analysis 2.10. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 10 Clinical failure (non–urinary tract infection).
[Analysis 2.11]
Analysis 2.11. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 11 Clinical failure (Gram-positive infection).
[Analysis 2.12]
Analysis 2.12. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 12 Need for operation (endocarditis).
[Analysis 2.13]
Analysis 2.13. Comparison 2 Monotherapy versus combination therapy (subgroup analyses), Outcome 13 Bacteriological failure (Gram-positive infection).
[Analysis 3.1]
Analysis 3.1. Comparison 3 Monotherapy versus combination therapy (sensitivity analyses), Outcome 1 All-cause mortality by allocation concealment.
[Analysis 3.2]
Analysis 3.2. Comparison 3 Monotherapy versus combination therapy (sensitivity analyses), Outcome 2 All-cause mortality by allocation generation.
[Analysis 3.3]
Analysis 3.3. Comparison 3 Monotherapy versus combination therapy (sensitivity analyses), Outcome 3 All-cause mortality by ITT versus per-protocol analysis.
[Analysis 3.4]
Analysis 3.4. Comparison 3 Monotherapy versus combination therapy (sensitivity analyses), Outcome 4 Clinical failure by allocation concealment.
[Analysis 3.5]
Analysis 3.5. Comparison 3 Monotherapy versus combination therapy (sensitivity analyses), Outcome 5 Clinical failure by allocation generation.
[Analysis 3.6]
Analysis 3.6. Comparison 3 Monotherapy versus combination therapy (sensitivity analyses), Outcome 6 Clinical failure by blinding.
[Analysis 3.7]
Analysis 3.7. Comparison 3 Monotherapy versus combination therapy (sensitivity analyses), Outcome 7 Clinical failure by ITT versus per-protocol analysis.