Carbapenem-Resistant GNB Infections Treatment

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What was the primary objective of the meta-analysis?

To compare the efficacy of colistin monotherapy and colistin-based combination therapy for treating carbapenem-resistant gram-negative bacteria infections (correct)

To examine the nephrotoxicity of colistin alone versus colistin in combination with other therapies

To evaluate the potential synergistic effects of combining colistin with various antibiotics

To determine the optimal dosage of colistin for treating infections caused by carbapenem-resistant Acinetobacter baumannii

What was the total number of patients included in the five randomized controlled trials?

1011

1201

501

791 (correct)

What was the outcome of the subgroup analysis regarding high or low dosage of colistin?

A significant difference was found in infection-related mortality

No significant difference was found in infection-related mortality or microbiologic response (correct)

A notable disparity was revealed in microbiologic response

A significant increase in nephrotoxicity was observed

What is the current preference for treating Acinetobacter strains that have developed resistance to carbapenems?

Colistin-based combination treatments Signup and view all the answers

What was the primary concern that led to the preference for colistin-based combination treatments over colistin monotherapy?

Nephrotoxicity Signup and view all the answers

What is the primary goal of the research examining the combination of colistin with other antibiotics?

To evaluate the potential synergistic effects of combining colistin with other antibiotics Signup and view all the answers

What percentage of strains exhibited synergistic effect between colistin and vancomycin?

17.4% Signup and view all the answers

Which antibiotic combination did not exhibit noticeable synergistic activity?

Colistin and tigecycline Signup and view all the answers

What percentage of strains showed synergistic inhibition when treated with a combination of colistin and meropenem at 24 hours after treatment?

100% Signup and view all the answers

What was the minimum inhibitory concentration (MIC) of meropenem above which the effectiveness of colistin was not substantially affected?

64 mg/L Signup and view all the answers

According to the IDSA guidelines, what is the recommended approach when treatment must be prolonged for an extended period of time?

Switch to a single active medication Signup and view all the answers

What percentage of studies examining the efficacy of combination therapy for the treatment of CRAB infections revealed a possible advantage for this approach?

12.5% Signup and view all the answers

What was the dosage of meropenem administered in the first study comparing colistin monotherapy to colistin and meropenem?

2 grams intravenously every 8 hours Signup and view all the answers

What was the 28-day mortality rate in the group receiving colistin alone in the first study?

46% Signup and view all the answers

What is the percentage of strains that demonstrated bactericidal action against colistin 48 hours after treatment?

91.7% Signup and view all the answers

What is the name of the guidelines that state that combination therapy enhances the eradication of pathogens?

IDSA Guidelines Signup and view all the answers

What was the 28-day mortality rate in the colistin monotherapy arm?

46% Signup and view all the answers

What was the clinical response rate in the meropenem/colistin group after 28 days?

75% Signup and view all the answers

What percentage of patients showed clinical improvement on day five in the colistin group?

16% Signup and view all the answers

How many articles compared the efficacy of a single treatment to that of a combination of therapies?

29 Signup and view all the answers

What was the primary composite outcome assessed in the AIDA randomized controlled trial?

Clinical failure at day 14 and mortality within 14 days Signup and view all the answers

How many patients were diagnosed with carbapenem-resistant Acinetobacter baumannii (CRAB) bacteraemia, ventilator-associated pneumonia (VAP), or hospital-acquired pneumonia in the AIDA trial?

312 Signup and view all the answers

What was the total daily dosage of the sulbactam component in the seventh investigation?

6 grams Signup and view all the answers

What is a proposed benefit of combination therapy for CRAB infections?

Increasing the likelihood of administering at least one active agent Signup and view all the answers

How many randomized controlled trials (RCTs) compared the efficacy of a single treatment to that of a combination of therapies?

6 Signup and view all the answers

What is a limitation of the observational studies evaluating CRAB treatment?

Low certainty Signup and view all the answers

What is the typical minimum inhibitory concentration (MIC) of Acinetobacter baumannii when it acquires carbapenem resistance?

Above 16 mg/L Signup and view all the answers

What is the recommended administration method for carbapenem combination treatments?

Prolonged or continuous infusion Signup and view all the answers

What was the conclusion of the three randomized controlled trials (RCTs) evaluating the efficacy of combining colistin and rifampin?

There is no superiority of colistin-rifampin combination treatment over colistin monotherapy Signup and view all the answers

What is the recommendation for patients with CRAB infections with a meropenem MIC?

Combination therapy including two in vitro active antibiotics Signup and view all the answers

What is the conclusion regarding the use of double covering combo therapy for CRAB?

There are few and inconclusive data to support the use of double covering combo therapy Signup and view all the answers

What is the general suggestion for treating CRAB infections?

Combination therapy with at least two active agents Signup and view all the answers