32 Questions
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
What was the total number of patients included in the five randomized controlled trials?
791
What was the outcome of the subgroup analysis regarding high or low dosage of colistin?
No significant difference was found in infection-related mortality or microbiologic response
What is the current preference for treating Acinetobacter strains that have developed resistance to carbapenems?
Colistin-based combination treatments
What was the primary concern that led to the preference for colistin-based combination treatments over colistin monotherapy?
Nephrotoxicity
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
What percentage of strains exhibited synergistic effect between colistin and vancomycin?
17.4%
Which antibiotic combination did not exhibit noticeable synergistic activity?
Colistin and tigecycline
What percentage of strains showed synergistic inhibition when treated with a combination of colistin and meropenem at 24 hours after treatment?
100%
What was the minimum inhibitory concentration (MIC) of meropenem above which the effectiveness of colistin was not substantially affected?
64 mg/L
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
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%
What was the dosage of meropenem administered in the first study comparing colistin monotherapy to colistin and meropenem?
2 grams intravenously every 8 hours
What was the 28-day mortality rate in the group receiving colistin alone in the first study?
46%
What is the percentage of strains that demonstrated bactericidal action against colistin 48 hours after treatment?
91.7%
What is the name of the guidelines that state that combination therapy enhances the eradication of pathogens?
IDSA Guidelines
What was the 28-day mortality rate in the colistin monotherapy arm?
46%
What was the clinical response rate in the meropenem/colistin group after 28 days?
75%
What percentage of patients showed clinical improvement on day five in the colistin group?
16%
How many articles compared the efficacy of a single treatment to that of a combination of therapies?
29
What was the primary composite outcome assessed in the AIDA randomized controlled trial?
Clinical failure at day 14 and mortality within 14 days
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
What was the total daily dosage of the sulbactam component in the seventh investigation?
6 grams
What is a proposed benefit of combination therapy for CRAB infections?
Increasing the likelihood of administering at least one active agent
How many randomized controlled trials (RCTs) compared the efficacy of a single treatment to that of a combination of therapies?
6
What is a limitation of the observational studies evaluating CRAB treatment?
Low certainty
What is the typical minimum inhibitory concentration (MIC) of Acinetobacter baumannii when it acquires carbapenem resistance?
Above 16 mg/L
What is the recommended administration method for carbapenem combination treatments?
Prolonged or continuous infusion
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
What is the recommendation for patients with CRAB infections with a meropenem MIC?
Combination therapy including two in vitro active antibiotics
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
What is the general suggestion for treating CRAB infections?
Combination therapy with at least two active agents
This quiz assesses your understanding of a meta-analysis comparing the efficacy of intravenous colistin monotherapy and colistin-based combination therapy for treating carbapenem-resistant gram-negative bacteria infections. Test your knowledge of the study's findings and implications.
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