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Empirical mono- versus combination antibiotic therapy in adult intensive care patients with severe sepsis – A systematic review with meta-analysis and trial sequential analysis by Fredrik Sjövall; Anders Perner; Morten Hylander Møller is a Medicine article available to read on EtoBox.

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## Objectives: To assess benefits and harms of empirical mono- vs. combination antibiotic therapy in adult patients with severe sepsis in the intensive care unit (icu). ## Methods: We performed a systematic review according to the cochrane collaboration methodology, including meta-analysis, risk of bias assessment and trial sequential analysis (tsa). we included randomised clinical trials (rct) assessing empirical mono-antibiotic therapy versus a combination of two or more antibiotics in adult icu patients with severe sepsis. we exclusively assessed patient-important outcomes, including mortality. two reviewers independently evaluated studies for inclusion, extracted data, and assessed risk of bias. risk ratios (rrs) with 95% confidence intervals (cis) were estimated and the risk of random errors was assessed by tsa. ## Results: Thirteen rcts (n = 2633) were included; all were judged as having high risk of bias. carbapenems were the most frequently used mono-antibiotic (8 of 13 trials). there was no difference in mortality (rr 1.11, 95% ci 0.95-1.29; p = 0.19) or in any other patient-important outcomes between mono- vs. combination therapy. in tsa of mortality, the z-curve reached

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Author

Fredrik Sjövall; Anders Perner; Morten Hylander Møller

Publisher

Elsevier BV

Published

2016

Language

EN

Field

Medicine (Health Sciences)