Evidence map›Paper›PMID 38739208›Full record

SynthesisInfection2024

Ceftazidime-avibactam combination therapy versus monotherapy for treating carbapenem-resistant gram-negative infection: a systemic review and meta-analysis.

Wei Hsu, Min-Hsiang Chuang, Wen-Wen Tsai, Chih-Cheng Lai, Hsin-Yu Lai, Hung-Jen Tang

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Infection, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline for antimicrobial treatment of multidrug-resistant Gram-negative infections: practice recommendations of the Brazilian Society of Infectious Diseases.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
    Guideline
  2. Article
  3. Observational
  4. Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2026
    Article
  5. Article
  6. Review
  7. Observational
  8. Therapeutic approach in the critically ill patient with suspected multidrug resistance.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025
    Review
  9. The importance of monitoring a new antibiotic: ceftazidime/avibactam usage and resistance experience from England, 2016 to 2020.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Wei HsuDepartment of Internal Medicine, Division of Hospital Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Min-Hsiang ChuangDepartment of Internal Medicine, Division of Hospital Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Wen-Wen TsaiDepartment of Neurology, Chi Mei Medical Center, Tainan, Taiwan.
Chih-Cheng LaiDepartment of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Hsin-Yu LaiDepartment of Internal Medicine, Division of Hospital Medicine, Chi Mei Medical Center, Tainan, Taiwan. cindy.hylai@gmail.com.
Hung-Jen TangDepartment of Internal Medicine, Division of Hospital Medicine, Chi Mei Medical Center, Tainan, Taiwan. 8409d1@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis meta-analysis was conducted to compare the efficacy of ceftazidime-avibactam combination therapy with that of monotherapy in the treatment of carbapenem-resistant Gram-negative bacterial (CR-GNB).

methodsA literature search of PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov was conducted until September 1, 2023. Only studies that compared CZA combination therapy with monotherapy for CR-GNB infections were included.

resultsA total of 25 studies (23 retrospective observational studies and 2 prospective studies) involving 2676 patients were included. There was no significant difference in 30-day mortality between the study group receiving combination therapy and the control group receiving monotherapy (risk ratio [RR] 0.91; 95% confidence interval [CI] 0.71-1.18). In addition, no significant differences were observed between the study and the control group in terms of in-hospital mortality (RR 1.00; 95% CI 0.79-1.27), 14-day mortality (RR 1.54; 95% CI 0.24-9.91), 90-day mortality (RR 1.18; 95% CI 0.62-2.22), and clinical cure rate (RR 0.95; 95% CI 0.84-1.08). However, the combination group had a borderline higher microbiological eradication rate than the control group (RR 1.15; 95% CI 1.00-1.32).

conclusionsCompared to monotherapy, CZA combination therapy did not yield additional clinical benefits. However, combination therapy may be associated with favorable microbiological outcomes.

Indexed as

Anti-Bacterial AgentsAzabicyclo CompoundsCarbapenemsCeftazidimeGram-Negative Bacterial InfectionsDrug CombinationsDrug Therapy, CombinationGram-Negative BacteriaHumansAnti-Bacterial Agentsavibactam, ceftazidime drug combinationAzabicyclo CompoundsCarbapenemsCeftazidimeDrug CombinationsCarbapenemsCeftazidime-avibactamCombination therapyMonotherapyMortality

Identifiers

PMID38739208

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.