Piperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review
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Piperacillin/tazobactam vs carbapenems for patients with bacterial infection : Protocol for a systematic review. / Petersen, Marie Warrer; Perner, Anders; Sjövall, Fredrik; Jonsson, Andreas Bender; Steensen, Morten; Andersen, Jakob Steen; Achiam, Michael Patrick; Frimodt-Møller, Niels; Møller, Morten Hylander.
In: Acta Anaesthesiologica Scandinavica, Vol. 63, No. 7, 08.2019, p. 973-978.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Piperacillin/tazobactam vs carbapenems for patients with bacterial infection
T2 - Protocol for a systematic review
AU - Petersen, Marie Warrer
AU - Perner, Anders
AU - Sjövall, Fredrik
AU - Jonsson, Andreas Bender
AU - Steensen, Morten
AU - Andersen, Jakob Steen
AU - Achiam, Michael Patrick
AU - Frimodt-Møller, Niels
AU - Møller, Morten Hylander
PY - 2019/8
Y1 - 2019/8
N2 - Introduction: Early empirical broad-spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β-lactam/β-lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem-sparing agent to reduce the incidence of multidrug-resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species. Whether these findings also apply to empirical piperacillin/tazobactam in patients with other severe infections, including sepsis, is unknown. We aim to assess the benefits and harms of empirical and definitive piperacillin/tazobactam vs carbapenems for patients with severe bacterial infections. Methods and analysis: This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement, the Cochrane Handbook and the Grading of Recommendations, Assessment, Development, and Evaluation approach. We will include randomised clinical trials assessing piperacillin/tazobactam vs carbapenems in patients with severe bacterial infections of any origin. The primary outcome will be all-cause short-term mortality ≤ 90 days. Secondary outcomes will include all-cause long-term mortality > 90 days, adverse events, quality of life, use of life support, secondary infections, antibiotic resistance, and length of stay. We will conduct meta-analyses, including pre-planned subgroup and sensitivity analyses for all assessed outcomes. The risk of random errors in the meta-analyses will be assessed by trial sequential analysis.
AB - Introduction: Early empirical broad-spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β-lactam/β-lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem-sparing agent to reduce the incidence of multidrug-resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species. Whether these findings also apply to empirical piperacillin/tazobactam in patients with other severe infections, including sepsis, is unknown. We aim to assess the benefits and harms of empirical and definitive piperacillin/tazobactam vs carbapenems for patients with severe bacterial infections. Methods and analysis: This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement, the Cochrane Handbook and the Grading of Recommendations, Assessment, Development, and Evaluation approach. We will include randomised clinical trials assessing piperacillin/tazobactam vs carbapenems in patients with severe bacterial infections of any origin. The primary outcome will be all-cause short-term mortality ≤ 90 days. Secondary outcomes will include all-cause long-term mortality > 90 days, adverse events, quality of life, use of life support, secondary infections, antibiotic resistance, and length of stay. We will conduct meta-analyses, including pre-planned subgroup and sensitivity analyses for all assessed outcomes. The risk of random errors in the meta-analyses will be assessed by trial sequential analysis.
U2 - 10.1111/aas.13382
DO - 10.1111/aas.13382
M3 - Journal article
C2 - 31020663
AN - SCOPUS:85064919059
VL - 63
SP - 973
EP - 978
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 7
ER -
ID: 240742790