Evidence map›Paper›PMID 41514364›Full record

ArticleTrials2026

Piperacillin-tazobactam/meropenem vs colistin/meropenem for carbapenem-resistant Klebsiella Pneumoniae-related ventilator-associated pneumonia.

Mohammad Mehdi Shadravan, Farid Javandoust Gharehbagh, Mohamad Amin Pourhoseingholi, Somaye Jahanabadi, Lida Lotfollahi, Ilad Alavi Darazam

Abstract readClinical Trial ProtocolComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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.

Mohammad Mehdi Shadravan *Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0002-0229-575X
Farid Javandoust Gharehbagh *Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0001-9127-9470
Mohamad Amin PourhoseingholiHearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Center, University of Nottingham, Nottingham, UK.ORCID http://orcid.org/0000-0002-0121-8031
Somaye JahanabadiInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0009-0000-1201-5929
Lida LotfollahiDepartment of Microbiology and Virology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.ORCID http://orcid.org/0000-0002-3522-7104
Ilad Alavi DarazamInfectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Ilad13@yahoo.com.ORCID http://orcid.org/0000-0002-4440-335X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVentilator-associated pneumonia (VAP) is a major concern in ICUs, particularly with carbapenem-resistant Klebsiella pneumoniae (CRKP). Dual beta-lactam antibiotic regimens may improve outcomes compared to traditional therapies. This study evaluates the efficacy and safety of meropenem/piperacillin-tazobactam versus meropenem/colistin for CRKP-related VAP. Primary outcomes are the change in Clinical Pulmonary Infection Score (CPIS) from baseline to Day 7, ICU length of stay, and ventilator-free days. Secondary outcomes include 28-day mortality, bacterial clearance, and renal or hepatic adverse events.

methodsThis randomized, open-label clinical trial will enroll 88 ICU patients with confirmed CRKP-related VAP. Participants will be randomly assigned to receive either meropenem/piperacillin-tazobactam or meropenem/colistin. The primary endpoints are improvement in CPIS, ICU length of stay, and ventilator-free days. Secondary endpoints include bacterial clearance and clinical recovery over 28 days. Safety will be assessed via renal and hepatic function monitoring and adverse event recording. Randomization and data collection follow SPIRIT 2013 guidelines to ensure rigor and transparency. DISCUSSION: Studies indicate that antibiotic combinations, particularly dual beta-lactam therapies, may enhance efficacy against resistant pathogens, including CRKP. While limited studies exist on dual beta-lactam regimens, recent findings suggest promising outcomes with combinations like meropenem/piperacillin-tazobactam. This study aims to provide robust evidence to address the gap in research and improve clinical guidelines for VAP management in ICU settings.

trial registrationThis trial was registered in the Iranian Registry of Clinical Trials (IRCT; available at https://irct.behdasht.gov.ir/ ; ID: IRCT20240229061132N1). Registered on March 16, 2025.

Indexed as

Anti-Bacterial AgentsCarbapenem-Resistant EnterobacteriaceaeColistinKlebsiella InfectionsKlebsiella pneumoniaePiperacillin, Tazobactam Drug CombinationPneumonia, Ventilator-AssociatedCarbapenemsHumansIntensive Care UnitsLength of StayMeropenemRandomized Controlled Trials as TopicTime FactorsTreatment OutcomeAnti-Bacterial AgentsCarbapenemsColistinMeropenemPiperacillin, Tazobactam Drug CombinationCarbapenem-resistant Klebsiella pneumoniaeDual beta-lactam therapyIntensive care unitVentilator-associated pneumonia

Identifiers

PMID41514364
PMCPMC12882293

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Registered trials

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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.