Combination Therapy Versus Monotherapy in the Treatment of Infections: A Systematic Review and Meta-Analysis

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2022 Dec 23

PMID 36551445

Authors

Abhisit Prawang

Naphatsawan Chanjamlong

Woranattha Rungwara

Wichai Santimaleeworagun

Taniya Paiboonvong

Thidarat Manapattanasatein

Prompiriya Pitirattanaworranat

Pongsakorn Kitseree

Sukrit Kanchanasurakit

Affiliations

Soon will be listed here.

Abstract

is a multidrug-resistant bacterium that is difficult to treat in hospitals worldwide, leading to high mortality. Published data describing the use of monotherapy or combination therapy and which one is better is still unclear. We aimed to investigate the efficacy of monotherapy and combination therapy in the treatment of infections. We performed a systematic review of combination therapy and additionally a systematic review and meta-analysis to determine the effects of monotherapy versus combination therapy on mortality in infections. Electronic databases: Cochrane Library, PubMed, Embase, ClinicalTrials.gov, Scopus, and OpenGrey were accessed. Of the 5030 articles identified, 17 studies were included for a systematic review of combination therapy, of which 4 cohort studies were finally included for meta-analysis. We found there is a trend of favorable outcomes with respect to mortality in the use of combination therapy to treat complex or severe infections. A meta-analysis of monotherapy showed a statistical significance in the decreasing rate of mortality in hospital-acquired pneumonia (hazard ratio 1.42; 95% confidence interval, 1.04-1.94) compared to combination therapy, but not significant in bacteremia (hazard ratio 0.76; 95% confidence interval, 0.18-3.18). Further studies should continue to explore this association.

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