The Role of Combination Antibiotic Therapy in Combatting Drug-Resistant

Anteneh Assefa Gezmu, Abel Workalemahu Tesfaye, Anthony R M Coates

Abstract readReview

In one paragraph

Review in Antibiotics (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing 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

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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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

3 authors.

Anteneh Assefa GezmuSt George's School of Health and Medical Sciences, City St George's University of London, Cranmer Terrace, London SW17 0RE, UK.

Abel Workalemahu TesfayeSchool of Public Health, Yekatit 12 Hospital Medical College, Addis Ababa P.O. Box 257, Ethiopia.

Anthony R M CoatesMedical Microbiology, St George's School of Health and Medical Sciences, City St George's University of London, Cranmer Terrace, London SW17 0RE, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background

methodsA systematic review of randomized controlled trials (RCTs) was conducted following PRISMA guidelines to evaluate the efficacy and safety of antibiotic combination therapy versus monotherapy for drug-resistant

resultsEight RCTs enrolling 324 participants were included. Most trials investigated colistin-based combinations (e.g., colistin plus rifampicin, meropenem, fosfomycin, or sitafloxacin); one assessed tigecycline plus cefoperazone-sulbactam. No regimen demonstrated a significant mortality or clinical cure benefit over monotherapy, despite some combinations showing earlier or higher microbiological clearance, most notably colistin-fosfomycin and colistin-rifampicin, without corresponding improvement in clinical outcomes. Adverse events, predominantly nephrotoxicity, were common but comparable across groups. Heterogeneity in trial size, infection severity, and resistance mechanisms limited cross-study comparability.

conclusionsCurrent RCT evidence does not support routine use of combination therapy over monotherapy for drug-resistant

Indexed as

Acinetobacter baumanniiantimicrobial resistancecarbapenem-resistant Acinetobacter baumanniicolistin-based therapycombination antibiotic therapyrandomized controlled trialssystematic review

Identifiers

PMID42041319

DOI10.3390/antibiotics15040356

PMCPMC13112964

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