In vitro activity of various antibiotics in Combination with tigecycline Against Acinetobacter baumannii: A systematic review and meta-analysis
Given that tigecycline-based combination is recognized as a valuable option to treat tigecycline resistant Acinetobacter baumannii (A.baumannii), we conducted this systematic review and meta-analysis to assess the overall evidence.Synergy rate was defined as the primary outcome which was calculated separately for time-kill, Etest and checkerboard microdilution methods.The secondary outcomes were bactericidal activity and the efficacy of combination treatment on resistant development.In total, 37 published papers and 16 conference proceedings were included.9 classes consisting of 22 antibiotic types in combination with tigecycline against 1159 A.baumannii strains were reported in the analysis.In time-kill studies, combination therapy showed synergy rates of 37.6% (95% CI, 28.9 to 47.2%), the highest synergy rate was 66.7% (95% CI, 19.6 to 94.2%) for tigecycline combined with colistin.Amikacin or colistin combination could efficiently inhibit the development of tigecycline resistance.Compared to checkerboard microdilution and Etest methods, time-kill studies always have higher synergy rates.Altogether, these results suggest that the in vitro tigecycline-based combinations produced moderate synergy rates and several combinations could suppress resistance of A.baumannii to tigecycline, which should be further confirmed in animal models and clinical trials.
Acinetobacter baumannii tigecycline-based combination in vitro meta-analysis synergy
李健 杨相海 陈丽丹 段欣冉 姜志辉
广州军区广州总医院药学部
国内会议
广州
英文
36-45
2017-12-16（万方平台首次上网日期，不代表论文的发表时间）