title: Meta-analysis of colistin for the treatment of Acinetobacter baumannii infection.
abstract: Multidrug resistant among Acinetobacter baumannii infection is associated with a high mortality rate and limits the therapeutic options. The aim of this study was to assess the safety and efficacy of colistin monotherapy vs. other single antibiotic therapy AND colistin-based combination therapy (with other antibiotics) vs. colistin alone for the treatment of Acinetobacter baumannii infection. Online electronic database were searched for studies evaluating colistin with or without other antibiotics in treatment of patients with drug-resistant Acinetobacter baumannii infection. Totally, twelve studies met the inclusion criteria. For colistin-based combination therapy, six articles including 668 patients were included. Our results showed that the overall clinical response did not differ significantly between colistin-based combination therapy and monotherapy (OR = 1.37, 95% CI = 0.86-2.19, P = 0.18). This insignificance was also detected in ICU mortality, length of stay and nephrotoxicity (P > 0.05). However, the colistin-based combination therapy was shown increasing the microbiological response (OR = 2.14, 95% CI = 1.48-3.07, P < 0.0001). For colistin monotherapy, six studies involving 491 patients were analyzed. The results were in concordance with the findings of the colistin-based combination therapy group. Our results suggest that colistin may be a promising therapy as safe and efficacious as standard antibiotics for the treatment of drug-resistant Acinetobacter baumannii infection.
authors.affiliation: Department of Hospital Infection-Control, Affiliated Houjie Hospital, Guangdong Medical College, Dongguan, Guangdong 523945, China.
authors.forename: Zhijin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Urology, Affiliated Hospital of Huzhou Teachers' College, The First People's Hospital of Hu zhou, Hu zhou, 313000, P.R. China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Hospital Infection-Control, Affiliated Houjie Hospital, Guangdong Medical College, Dongguan, Guangdong 523945, China.
authors.forename: Yaogao
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Hospital Infection-Control, Affiliated Houjie Hospital, Guangdong Medical College, Dongguan, Guangdong 523945, China.
authors.forename: Xiaotian
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Hospital Infection-Control, Affiliated Houjie Hospital, Guangdong Medical College, Dongguan, Guangdong 523945, China.
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Hospital Infection-Control, Affiliated Houjie Hospital, Guangdong Medical College, Dongguan, Guangdong 523945, China.
authors.forename: Qingsong
authors.initials: Q
authors.lastname: Qi
authors.affiliation: Department of Hospital Infection-Control, Affiliated Houjie Hospital, Guangdong Medical College, Dongguan, Guangdong 523945, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Huang
authors.affiliation: Department of Joint Surgery, Chenzhou NO.1 People's Hospital, Hunan Province, 423000 P.R. China.
authors.forename: Xungang
authors.initials: X
authors.lastname: Xiao
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003091:Colistin / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D004359:Drug Therapy, Combination; D006801:Humans; D007902:Length of Stay; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin