title: Efficacy of sulbactam for the treatment of Acinetobacter baumannii complex infection: A systematic review and meta-analysis.
abstract: Meta-analyses that ignore the full programme of clinical trials may lead to a misleading interpretation. We did a comprehensive meta-analysis to explore the efficacy of sulbactam for the treatment of Acinetobacter baumannii complex infection. We searched electronic databases, including Pubmed and Embase up to April 24, 2016, to identify relevant published trials. Clinical trial registries were likewise searched to identify completed unpublished studies. Primary outcomes of interest were the clinical and microbiological efficacy and in-hospital mortality. Effect model was based on heterogeneity across studies. Altogether 12 observational trials, comprising about 1500 patients, were included. Compared with control group, the clinical response (OR 1.16, 95% CI 0.77-1.75), bacteriological response (OR 1.71, 95% CI 0.89-3.29) and in-hospital mortality (OR 0.76, 95% CI 0.57-1.01) of sulbactam-based therapy group achieved similar therapeutic in A. baumannii complex infection. Subgroup analysis showed the clinical response (OR 1.66, 95% CI 1.11-2.48) of A. baumannii complex infection favored high-dose sulbactam group. In conclusion, our findings suggested that the overall therapy effect of sulbactam was no more superior than alternative therapeutics. However, when taking consideration of the dose factor, we found that high dosage regimen of sulbactam showed an obvious advantage in the treatment of A. baumannii complex infection.
authors.affiliation: Department of Laboratory Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China.
authors.forename: Haojun
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, Chengdu First People's Hospital, Chengdu 610041, Sichuan, China; Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Laboratory Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China.
authors.forename: Zhanguo
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Laboratory Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China. Electronic address: congrongli33@163.com.
authors.forename: Congrong
authors.initials: C
authors.lastname: Li
mesh_terms: D000151:Acinetobacter Infections / Q000188:drug therapy*; D040981:Acinetobacter baumannii / Q000187:drug effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D017052:Hospital Mortality; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D064887:Observational Studies as Topic; D013407:Sulbactam / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D013407:Sulbactam
keywords: Acinetobacter baumannii complex; Meta-analysis; Sulbactam; Treatment