HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Siempos, I. I. Articles by Falagas, M. E. Search for Related Content PubMed PubMed Citation Articles by Siempos, I. I. Articles by Falagas, M. E.

Carbapenems for the treatment of immunocompetent adult patients with nosocomial pneumonia

¹ Alfa Institute of Biomedical Sciences and ² Dept of Medicine, Henry Dunant Hospital, Athens, Greece. ³ Dept of Medicine, Tufts University School of Medicine, Boston, MA, USA.

CORRESPONDENCE: M. E. Falagas, Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece. Fax: 30 2106839605. E-mail: m.falagas{at}aibs.gr

Keywords: Acinetobacter baumannii, ß-lactams, intensive care unit, meropenem, Pseudomonas aeruginosa, ventilator-acquired pneumonia

Received: June 19, 2006
Accepted September 8, 2006

The comparative effectiveness and safety of carbapenems with other ß-lactams and fluoroquinolones for the empirical treatment of patients with hospital-acquired pneumonia remains controversial.

In the present study, a meta-analysis of 12 relevant randomised controlled trials was performed.

Overall, carbapenems were associated with lower mortality than fluoroquinolones or ß-lactams, alone or in combination with aminoglycosides (odds ratio 0.72, 95% confidence interval 0.55–0.95). There was no difference between the compared antibiotics regarding treatment success (1.08, 0.91–1.29), microbiological success (1.04, 0.72–1.50) or development of adverse effects (0.81, 0.46–1.43). In the subset of patients with Pseudomonas aeruginosa pneumonia, carbapenems were associated with lower treatment success (0.42, 0.22–0.82) and lower eradication of P. strains (0.50, 0.24–0.89).

Carbapenems are equivalent to fluoroquinolones or ß-lactams, alone or in combination with aminoglycosides, for the empirical treatment of immunocompetent adult patients with hospital-acquired pneumonia. However, there is limited evidence, based predominantly on unblinded randomised controlled trials, that carbapenems are associated with lower mortality than the comparators; this association was not observed in a subset analysis of randomised controlled trials with a high methodological quality score. In patients with Pseudomonas aeruginosa pneumonia, carbapenems are associated with worse outcomes than the comparators.

This article has been cited by other articles:

				I. I. Siempos, G. Dimopoulos, and M. E. Falagas From the authors Eur. Respir. J., April 1, 2008; 31(4): 907 - 908. [Full Text] [PDF]

				I. I. Siempos, G. Dimopoulos, and M. E. Falagas From the authors Eur. Respir. J., October 1, 2007; 30(4): 815 - 816. [Full Text] [PDF]