Observational studyCritical care medicine2015
Excess Mortality Associated With Colistin-Tigecycline Compared With Colistin-Carbapenem Combination Therapy for Extensively Drug-Resistant Acinetobacter baumannii Bacteremia: A Multicenter Prospective Observational Study.
Observational study in Critical care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04202861 (A Randomised Controlled Trial Evaluating a Novel Individualised Treatment Strategy for Carbapenem-Resistant Gram-Negative Bacteria Infections), which is not on this map. Cited by 70 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
A Randomised Controlled Trial Evaluating a Novel Individualised Treatment Strategy for Carbapenem-Resistant Gram-Negative Bacteria Infections (iACT)
Who cites it
70 citing papers in PubMed, 2 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- 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
- The efficacy and safety of tigecycline for the treatment of bloodstream infections: a systematic review and meta-analysis.Annals of clinical microbiology and antimicrobials · 2017Pooled it
- Single- and Multiple-Ascending-Dose Study of the Safety, Tolerability, and Pharmacokinetics of the Polymyxin Derivative SPR206.Antimicrobial agents and chemotherapy · 2021Trial
- Safety, Pharmacokinetics, and Drug-Drug Interaction Potential of Intravenous Durlobactam, a β-Lactamase Inhibitor, in Healthy Subjects.Antimicrobial agents and chemotherapy · 2020Trial
- Pharmacokinetics and Tolerability of Intravenous Sulbactam-Durlobactam with Imipenem-Cilastatin in Hospitalized Adults with Complicated Urinary Tract Infections, Including Acute Pyelonephritis.Antimicrobial agents and chemotherapy · 2020Trial
- Correlation of Checkerboard Synergy Testing with Time-Kill Analysis and Clinical Outcomes of Extensively Drug-Resistant Acinetobacter baumannii Respiratory Infections.Antimicrobial agents and chemotherapy · 2016Trial
- Reply to Chirumbolo, "Antimicrobial regimens for the treatment of pan-drug-resistantAntimicrobial agents and chemotherapy · 2026Article
- Trends of Multidrug-Resistant Gram-Negative Bacteria in Tamale Metropolis, Ghana (2020-2023).Antibiotics (Basel, Switzerland) · 2026Article
- Comparative analysis of treatment outcomes and risk factors associated with different combination antimicrobial regimens in patients with multidrug-resistant Acinetobacter baumannii pneumonia.Frontiers in cellular and infection microbiology · 2026Article
- Safety and Efficacy of Nebulized Inhalation of Polymyxin B Sulfate for Carbapenem-Resistant Gram-Negative Bacterial Pneumonia: A Multi-Center, Prospective, Observational Study.Infection and drug resistance · 2026Article
- Turning the Tide Against Carbapenem-resistantOpen forum infectious diseases · 2025Article
- An Evaluation of Alternative Treatment Strategies in Mitigating Colistin Resistance: Targeting Plasmid Transfer Through the Use of Bambermycin or the Protein Coded by the Mcr-1 Gene With Antibodies and Streptomycin.Veterinary medicine and science · 2025Article
- Mortality and clinical outcomes of colistin versus colistin-based combination therapy for infections caused by Multidrug-resistant Acinetobacter baumannii in critically ill patients.BMC infectious diseases · 2025Observational
- Multidrug resistantCurrent research in microbial sciences · 2025Review
- Antibiotic Resistance Trends in Carbapenem-Resistant Gram-Negative Pathogens and Eight-Year Surveillance of XDR Bloodstream Infections in a Western Greece Tertiary Hospital.Pathogens (Basel, Switzerland) · 2024Article
- The challenges of difficult-to-treatClinical microbiology reviews · 2024Review
- Detection and molecular characterization of carbapenem-resistant gram-negative bacterial isolates.AMB Express · 2024Article
- Comparison of Hypervirulent and Non-Hypervirulent Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2024Article
- Current Therapeutic Approaches for Multidrug-Resistant and Extensively Drug-ResistantAntibiotics (Basel, Switzerland) · 2024Review
- Risk Factors Associated with Mortality inAntibiotics (Basel, Switzerland) · 2024Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSince few therapeutic options exist for extensively drug resistant Acinetobacter baumannii, an emerging threat in ICUs worldwide, and comparative prospective studies of colistin-based combination therapies are lacking, our objective was to compare the outcomes of patients with extensively drug-resistant A. baumannii bacteremia, treated with colistin-carbapenem and colistin-tigecycline combinations.
designProspective, observational, multicenter study. SETTING, PATIENTS, AND
interventionsAdults with extensively drug-resistant A. baumannii bacteremia were prospectively followed from 2010 to 2013 at three hospitals in Taiwan. Extensively drug-resistant A. baumannii was defined as A. baumannii (genospecies 2) nonsusceptible to all drug classes except for colistin and tigecycline, and standard combination therapy as use of parenteral colistin-carbapenem or colistin-tigecycline for at least 48 hours after onset of bacteremia. MEASUREMENTS AND MAIN
resultsPrimary outcome measure was 14-day mortality. Of the 176 episodes of extensively drug-resistant A. baumannii bacteremia evaluated, 55 patients with a median (interquartile range) age of 62 years (44-79 yr) and Sequential Organ Failure Assessment score of 9 (5-13) points received standard combination therapy: colistin-tigecycline in 29 patients and colistin-carbapenem in 26. Crude 14-day and in-hospital mortality rates for patients receiving colistin-tigecycline versus patients receiving colistin-carbapenem were 35% versus 15% (p=0.105) and 69% versus 50% (p=0.152), respectively. Breakthrough extensively drug-resistant A. baumannii bacteremia under steady state concentrations of combination therapy for colistin-tigecycline group was 18% and for colistin-carbapenem group was 0% (p=0.059). Eleven patients (20.0%) developed nephrotoxicity. After adjusting for age, sex, comorbidity, initial disease severity, loading colistin dose, polymicrobial infection, and primary infection site, excess 14-day mortality was associated with the use of colistin-tigecycline in the subgroup with tigecycline minimum inhibitory concentration greater than 2 mg/L compared with the use of colistin-carbapenem (hazard ratio, 6.93; 95% CI, 1.61-29.78; p=0.009).
conclusionsIncreased 14-day mortality was associated with colistin-tigecycline therapy given tigecycline minimum inhibitory concentration greater than 2 mg/L compared with colistin-carbapenem therapy for extensively drug-resistant A. baumannii bacteremia.
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