SynthesisAnnals of clinical microbiology and antimicrobials2017
Triple combination antibiotic therapy for carbapenemase-producing Klebsiella pneumoniae: a systematic review.
Synthesis in Annals of clinical microbiology and antimicrobials, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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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
20 citing papers in PubMed, 42 citations in OpenAlex.
- Synergistic Interactions Between Natural Phenolic Compounds and Antibiotics Against Multidrug-ResistantMicroorganisms · 2025Article
- Liposomal Fluopsin C: Physicochemical Properties, Cytotoxicity, and Antibacterial Activity In Vitro and over In Vivo MDRAntibiotics (Basel, Switzerland) · 2025Article
- Emergence of pandrug-resistant carbapenemase-producingFrontiers in cellular and infection microbiology · 2024Article
- Characteristics of antibiotic resistance mechanisms and genes ofOpen medicine (Warsaw, Poland) · 2023Review
- Prevalence of polymyxin-induced nephrotoxicity and its predictors in critically ill adult patients: A meta-analysis.World journal of clinical cases · 2022Article
- Causative organisms and antimicrobial susceptibility in jaundiced infants with significant bacteriuria.Journal of the Chinese Medical Association : JCMA · 2022Article
- Biogenic Silver Nanoparticles Strategically Combined WithFrontiers in microbiology · 2022Article
- Analysis of Risk Factors and Mortality of Patients with Carbapenem-ResistantInfection and drug resistance · 2022Article
- Polymyxin B Pharmacodynamics in the Hollow-Fiber Infection Model: What You See May Not Be What You Get.Antimicrobial agents and chemotherapy · 2021Article
- Evaluation Strategies for Triple-Drug Combinations against Carbapenemase-Producing Klebsiella Pneumoniae in an In Vitro Hollow-Fiber Infection Model.Clinical pharmacology and therapeutics · 2021Article
- Polymyxin Triple Combinations against Polymyxin-Resistant, Multidrug-Resistant, KPC-Producing Klebsiella pneumoniae.Antimicrobial agents and chemotherapy · 2020Article
- Detection of two simultaneous outbreaks of Klebsiella pneumoniae coproducing OXA-48 and NDM-1 carbapenemases in a tertiary-care hospital in Valencia, Spain.New microbes and new infections · 2020Article
- When Combined with Colistin, an Otherwise Ineffective Rifampicin-Linezolid Combination Becomes Active inMicroorganisms · 2020Article
- Prevalence of Klebsiella pneumoniae carbapenemase - and New Delhi metallo-beta-lactamase-positive K. pneumoniae in Sergipe, Brazil, and combination therapy as a potential treatment option.Revista da Sociedade Brasileira de Medicina Tropical · 2020Article
- Low-Frequency Ultrasound Enhances Bactericidal Activity of Antimicrobial Agents againstBioMed research international · 2020Article
- Rapid Identification of Carbapenemase-producingThe Eurasian journal of medicine · 2019Article
- NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings.Clinical microbiology reviews · 2019Review
- Effective targeted therapy for drug-resistant infection by ICAM-1 antibody-conjugated TPGS modified β-GaTheranostics · 2019Article
- A Fatal Bacteremia Caused by Hypermucousviscous KPC-2 Producing Extensively Drug-Resistant K64-ST11Frontiers in medicine · 2018Article
- Early use of polymyxin B reduces the mortality of carbapenem-resistant Klebsiella pneumoniae bloodstream infection.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesObservational
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe spread of carbapenemase-producing K. pneumoniae (CPKP) has become a significant problem worldwide. Combination therapy for CPKP is encouraging, but polymyxin resistance to many antibiotics is hampering effective treatment. Combination therapy with three or more antibiotics is being increasingly reported, therefore we performed a systematic review of triple combination cases in an effort to evaluate their clinical effectiveness for CPKP infections.
methodsThe PubMed database was searched to identify all published clinical outcomes of CPKP infections treated with triple combination therapy. Articles were stratified into two tiers depending on the level of clinical detail provided. A tier 1 study included: antibiotic regimen, regimen-specific outcome, patient status at onset of infection, and source of infection. Articles not reaching these criteria were considered tier 2.
resultsThirty-three studies were eligible, 23 tier 1 and ten tier 2. Among tier 1 studies, 53 cases were included in this analysis. The most common infection was pneumonia (31%) followed by primary or catheter-related bacteremia (21%) and urinary tract infection (17%). Different combinations of antibiotic classes were utilized in triple combinations, the most common being a polymyxin (colistin or polymyxin B, 86.8%), tigecycline (73.6%), aminoglycoside (43.4%), or carbapenem (43.4%). Clinical and microbiological failure occurred in 14/39 patients (35.9%) and 22/42 patients (52.4%), respectively. Overall mortality for patients treated with triple combination therapy was 35.8% (19/53 patients).
conclusionsTriple combination therapy is being considered as a treatment option for CPKP. Polymyxin-based therapy is the backbone antibiotic in these regimens, but its effectiveness needs establishing in prospective clinical trials.
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