Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
The Impact of Synergistic Therapy Between Colistin and Meropenem on Outcomes of People With Pneumonia or Bloodstream Infection Due to Carbapenem-Resistant Gram-Negative Pathogens.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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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
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pharmacokinetic-pharmacodynamic modeling using combined time-kill data for meropenem and colistin or polymyxin B combination effects inAntimicrobial agents and chemotherapy · 2026Pooled it
- Comparative Neurotoxicity of Polymyxin B and Colistin in Patients With Cancer.Pharmacotherapy · 2026Article
- Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Review
- Outer membrane vesicles of carbapenem-resistantMicrobiology spectrum · 2026Article
- Treating Extensively Drug-ResistantPathogens (Basel, Switzerland) · 2026Review
- Extended vs Intermittent Infusion of Meropenem with Colistimethate Sodium and Risk of Acute Kidney Injury in Critically Ill Patients: A Propensity Score-Matched Retrospective Cohort Study.Infection and drug resistance · 2026Article
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33 authors.
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Abstract
backgroundColistin, a last-line treatment for carbapenem-resistant Gram-negative bacilli (CRGNB), is frequently used in combination with meropenem because these agents often demonstrate in vitro synergy. Using data from the OVERCOME trial comparing colistin + meropenem to colistin + placebo for treatment of pneumonia or bloodstream infection due to CRGNB, we evaluated the impact of synergistic therapy on outcomes.
methodsIn vitro synergy testing between colistin and meropenem was conducted using 24-hour time-kill analysis; synergy was defined as >2-log reduction in colony-forming units/mL compared to the most active single agent. Patients receiving synergistic combination therapy were compared to patients receiving functional colistin monotherapy (colistin alone or combination therapy without synergy). Outcomes included mortality, clinical failure, and microbiologic cure. Adjusted analyses controlled for variables on which randomization was stratified and confounders.
resultsA total of 146 subjects receiving synergistic combination therapy and 261 subjects receiving functional monotherapy were included. Most had pneumonia (70%), CR Acinetobacter baumannii infection (79%) and were in intensive care (69%). Acinetobacter baumannii was more common in those receiving synergistic combination therapy than functional monotherapy (P < .001). Mortality rates were similar (38.3% and 41.4%, respectively). In adjusted analyses, synergistic combination therapy was associated with significantly lower clinical failure rates (55.3%, 64.3%, adjusted odds ratio [aOR] 0.62, P = .049), with consistent findings in pneumonia (62.6%, 71.8%, aOR 0.55, P = .04) and A. baumannii subgroups (57.4%, 69.4%, aOR 0.60, P = .06). Microbiologic cure rates were similar.
conclusionsColistin-based, synergistic combination treatment with meropenem (compared to nonsynergistic colistin-based therapy) was associated with decreased clinical failure, particularly in people with pneumonia and A. baumannii.
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