Piperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review

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Piperacillin/tazobactam vs carbapenems for patients with bacterial infection : Protocol for a systematic review. / Petersen, Marie Warrer; Perner, Anders; Sjövall, Fredrik; Jonsson, Andreas Bender; Steensen, Morten; Andersen, Jakob Steen; Achiam, Michael Patrick; Frimodt-Møller, Niels; Møller, Morten Hylander.

I: Acta Anaesthesiologica Scandinavica, Vol. 63, Nr. 7, 08.2019, s. 973-978.

Forskningsoutput: TidskriftsbidragÖversiktsartikel

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Petersen, MW, Perner, A, Sjövall, F, Jonsson, AB, Steensen, M, Andersen, JS, Achiam, MP, Frimodt-Møller, N & Møller, MH 2019, 'Piperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review', Acta Anaesthesiologica Scandinavica, vol. 63, nr. 7, s. 973-978. https://doi.org/10.1111/aas.13382

APA

CBE

Petersen MW, Perner A, Sjövall F, Jonsson AB, Steensen M, Andersen JS, Achiam MP, Frimodt-Møller N, Møller MH. 2019. Piperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review. Acta Anaesthesiologica Scandinavica. 63(7):973-978. https://doi.org/10.1111/aas.13382

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Petersen, Marie Warrer ; Perner, Anders ; Sjövall, Fredrik ; Jonsson, Andreas Bender ; Steensen, Morten ; Andersen, Jakob Steen ; Achiam, Michael Patrick ; Frimodt-Møller, Niels ; Møller, Morten Hylander. / Piperacillin/tazobactam vs carbapenems for patients with bacterial infection : Protocol for a systematic review. I: Acta Anaesthesiologica Scandinavica. 2019 ; Vol. 63, Nr. 7. s. 973-978.

RIS

TY - JOUR

T1 - Piperacillin/tazobactam vs carbapenems for patients with bacterial infection

T2 - Protocol for a systematic review

AU - Petersen, Marie Warrer

AU - Perner, Anders

AU - Sjövall, Fredrik

AU - Jonsson, Andreas Bender

AU - Steensen, Morten

AU - Andersen, Jakob Steen

AU - Achiam, Michael Patrick

AU - Frimodt-Møller, Niels

AU - Møller, Morten Hylander

N1 - © 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2019/8

Y1 - 2019/8

N2 - INTRODUCTION: Early empirical broad-spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β-lactam/β-lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem-sparing agent to reduce the incidence of multidrug-resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species. Whether these findings also apply to empirical piperacillin/tazobactam in patients with other severe infections, including sepsis, is unknown. We aim to assess the benefits and harms of empirical and definitive piperacillin/tazobactam vs carbapenems for patients with severe bacterial infections.METHODS AND ANALYSIS: This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement, the Cochrane Handbook and the Grading of Recommendations, Assessment, Development, and Evaluation approach. We will include randomised clinical trials assessing piperacillin/tazobactam vs carbapenems in patients with severe bacterial infections of any origin. The primary outcome will be all-cause short-term mortality ≤ 90 days. Secondary outcomes will include all-cause long-term mortality > 90 days, adverse events, quality of life, use of life support, secondary infections, antibiotic resistance, and length of stay. We will conduct meta-analyses, including pre-planned subgroup and sensitivity analyses for all assessed outcomes. The risk of random errors in the meta-analyses will be assessed by trial sequential analysis.

AB - INTRODUCTION: Early empirical broad-spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β-lactam/β-lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem-sparing agent to reduce the incidence of multidrug-resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species. Whether these findings also apply to empirical piperacillin/tazobactam in patients with other severe infections, including sepsis, is unknown. We aim to assess the benefits and harms of empirical and definitive piperacillin/tazobactam vs carbapenems for patients with severe bacterial infections.METHODS AND ANALYSIS: This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement, the Cochrane Handbook and the Grading of Recommendations, Assessment, Development, and Evaluation approach. We will include randomised clinical trials assessing piperacillin/tazobactam vs carbapenems in patients with severe bacterial infections of any origin. The primary outcome will be all-cause short-term mortality ≤ 90 days. Secondary outcomes will include all-cause long-term mortality > 90 days, adverse events, quality of life, use of life support, secondary infections, antibiotic resistance, and length of stay. We will conduct meta-analyses, including pre-planned subgroup and sensitivity analyses for all assessed outcomes. The risk of random errors in the meta-analyses will be assessed by trial sequential analysis.

U2 - 10.1111/aas.13382

DO - 10.1111/aas.13382

M3 - Review article

VL - 63

SP - 973

EP - 978

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 7

ER -