Colistin for the treatment of ventilator-associated pneumonia caused by multidrug-resistant Gram-negative bacteria: a systematic review and meta-analysis.

摘要: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) has emerged as an important and intractable clinical problem. This review assessed the efficacy safety of colistin for treatment MDR GNB VAP. PubMed Embase were searched controlled studies The Mantel-Haenszel random-effects model was used to pool odds ratios (ORs) with 95% confidence intervals (CIs). primary outcome cure; secondary outcomes microbiological eradication, ICU mortality, hospital length stay nephrotoxicity. Fourteen involving 1167 patients identified, including six reporting versus β-lactam antibiotics, three aerosolised (AS) plus intravenous (IV) IV alone five combined therapy monotherapy. cure rate comparable that antibiotics (OR=1.00, CI 0.68-1.47). Compared alone, AS exhibited a better (OR=2.12, 1.40-3.20). monotherapy, did not appear provide (OR=1.38, 0.81-2.33). There no significant difference in nephrotoxicity other between groups. Colistin appears effective safe may be beneficial adjunct management does compared