SynthesisEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2014
Combination antibiotic treatment versus monotherapy for multidrug-resistant, extensively drug-resistant, and pandrug-resistant Acinetobacter infections: a systematic review.
Synthesis in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
61 citing papers in PubMed, 6 syntheses or guidelines pooled it, 121 citations in OpenAlex.
- Resistance ofPathogens (Basel, Switzerland) · 2025Pooled it
- Global Epidemiology and Antimicrobial Resistance of Metallo-β-Lactamase (MBL)-Producing Acinetobacter Clinical Isolates: A Systematic Review.Pathogens (Basel, Switzerland) · 2025Pooled it
- [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Guideline
- Choice of therapeutic interventions and outcomes for the treatment of infections caused by multidrug-resistant gram-negative pathogens: a systematic review.Antimicrobial resistance and infection control · 2019Pooled it
- Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.Intensive care medicine · 2017Guideline
- Task force on management and prevention of Acinetobacter baumannii infections in the ICU.Intensive care medicine · 2015Guideline
- Clinical features, antimicrobial susceptibilities, treatment characteristics and outcomes of paediatric Acinetobacter lwoffii bacteremia: a case series.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Strategic re-engineering of antibiotics.Nature reviews bioengineering · 2025Article
- Mechanisms in colistin-resistant superbugs transmissible from veterinary, livestock and animal food products to humans.Iranian journal of veterinary research · 2025Review
- Article
- The intricacies ofFrontiers in microbiology · 2025Review
- Epidemiology, Clinical Characteristics and Treatment Outcomes ofInfection and drug resistance · 2025Article
- Guanethidine Enhances the Antibacterial Activity of Rifampicin Against Multidrug-Resistant Bacteria.Microorganisms · 2024Article
- Molecular Mechanisms of Bacterial Resistance to Antimicrobial Peptides in the Modern Era: An Updated Review.Microorganisms · 2024Review
- Article
- Efficacy of Fosfomycin-Containing Regimens for Treatment of Bacteremia Due to Pan-Drug ResistantPathogens (Basel, Switzerland) · 2023Article
- Clearance of blood stream infections in patients receiving extracorporeal membrane oxygenation: a retrospective single-center cohort study.BMC infectious diseases · 2023Article
- Molecular epidemiology and antimicrobial resistance patterns of carbapenem-resistantFrontiers in cellular and infection microbiology · 2023Article
- Treatment effectiveness of antibiotic therapy in Veterans with multidrug-resistantAntimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Molecular mechanisms of multidrug resistance in clinically relevant enteropathogenic bacteria (Review).Experimental and therapeutic medicine · 2022Review
1 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Controversy surrounds combination treatment or monotherapy against multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) Acinetobacter infections in clinical practice. We searched the PubMed and Scopus databases for studies reporting on the clinical outcomes of patients infected with MDR, XDR, and PDR Acinetobacter spp. with regard to the administered intravenous antibiotic treatment. Twelve studies reporting on 1,040 patients suffering from 1,044 infectious episodes of MDR Acinetobacter spp. were included. The overall mortality between studies varied from 28.6 to 70 %; from 25 to 100 % in the monotherapy arm and from 27 to 57.1 % in the combination arm. Combination treatment was superior to monotherapy in three studies, where carbapenem with ampicillin/sulbactam (mortality 30.8 %, p = 0.012), carbapenem with colistin (mortality 23 %, p = 0.009), and combinations of colistin with rifampicin, sulbactam with aminoglycosides, tigecycline with colistin and rifampicin, and tigecycline with rifampicin and amikacin (mortality 27 %, p < 0.05) were used against MDR Acinetobacter spp. resistant at least to carbapenems. The benefit was not validated in the remaining studies. Clinical success varied from 42.4 to 76.9 % and microbiological eradication varied from 32.7 to 67.3 %. Adverse events referred mainly to polymixins nephrotoxicity that varied from 19 to 50 %. The emergence of resistance was noted with tigecycline regimens in off-label uses in three studies. The available data preclude a firm recommendation with regard to combination treatment or monotherapy. For the time being, combination treatment may be preferred for severely ill patients. We urge for randomized controlled trials examining the optimal treatment of infections due to MDR, XDR, and PDR Acinetobacter spp.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.