Triple combination antibiotic therapy for carbapenemase-producing Klebsiella pneumoniae: a systematic review

Jacobs, David M.; Safir, M. Courtney; Huang, Dennis; Minhaj, Faisal; Parker, Adam; Rao, Gauri G.

doi:10.1186/s12941-017-0249-2

Annals of Clinical Microbiology and Antimicrobials

Table 1 Summary of outcomes and antimicrobial therapy for carbapenemase-producing K. pneumoniae infections found in tier 1 articles

From: Triple combination antibiotic therapy for carbapenemase-producing Klebsiella pneumoniae: a systematic review

First Author (no. of subjects) [References]	Clinical failure^d	Microbiologic failure^d	Mortality	Combination antimicrobial therapy
First Author (no. of subjects) [References]	Clinical failure^d	Microbiologic failure^d	Mortality	PMB/COL	TCN	AMG	CARB	FOS	PCN	FQ
Ariza-Heredia (n = 1) [18]	–	1/1 (100%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)	1/1 (100%)
Balandin Moreno (n = 3) [31]	–	2/3 (66.7%)	0/3 (0%)	2/3 (66.7%)	3/3 (100%)	1/3 (33.3%)	2/3 (66.7%)	0/3 (0%)	0/3 (0%)	1/3 (33.3%)
Camargo (n = 1) [19]	–	1/1 (100%)	0/1 (0%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
Chua^a (n = 2) [20]	0/2 (0%)	0/2 (0%)	0/2 (0%)	2/2 (100%)	0/2 (0%)	0/2 (0%)	2/2 (100%)	0/2 (0%)	0/2 (0%)	0/2 (0%)
Cicora (n = 5) [32]	–	4/5 (80%)	1/5 (20%)	3/5 (60%)	5/5 (100%)	0/5 (0%)	3/5 (60%)	4/5 (80%)	0/5 (0%)	0/5 (0%)
Clancy (n = 1) [33]	0/1 (0%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
de Sanctis (n = 1) [21]	–	1/1 (100%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
Giamarellou (n = 1) [22]	1/1 (100%)	1/1 (100%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)
Lemmenmeier (n = 3) [23]	0/3 (0%)	–	0/3 (0%)	3/3 (100%)	3/3 (100%)	0/3 (0%)	3/3 (100%)	0/3 (0%)	0/3 (0%)	0/3 (0%)
Lubbert (n = 4) [37]	3/4 (75.0%)	–	3/4 (75%)	4/4 (100%)	4/4 (100%)	4/4 (100%)	0/4 (0%)	0/4 (0%)	0/4 (0%)	0/4 (0%)
Maltezou (n = 2) [38]	0/2 (0%)	2/2 (100%)	0/2 (0%)	2/2 (100%)	2/2 (100%)	2/2 (100%)	0/2 (0%)	0/2 (0%)	0/2 (0%)	0/2 (0%)
Marquez^b (n = 1) [24]	1/1 (100%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
Mathers^c (n = 1) [25]	0/1 (0%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	0/1 (0%)
Morris (n = 1) [39]	0/1 (0%)	–	0/1 (0%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
Mouloudi (n = 4) [40]	1/4 (25.0%)	1/4 (25%)	2/4 (50%)	4/4 (100%)	4/4 (100%)	4/4 (100%)	0/4 (0%)	0/4 (0%)	0/4 (0%)	0/4 (0%)
Navarro (n = 2) [41]	–	–	2/2 (100%)	2/2 (100%)	2/2 (100%)	2/2 (100%)	0/2 (0%)	0/2 (0%)	0/2 (0%)	0/2 (0%)
Nevrekar (n = 1) [26]	0/1 (0%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
Oliva^a (n = 1) [27]	0/1 (0%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
Pontikis (n = 9) [28]	5/9 (55.6%)	4/9 (44.4%)	4/9 (44.4%)	8/9 (88.9%)	4/9 (44.4%)	2/9 (22.2%)	3/9 (33.3%)	9/9 (100%)	2/9 (22.2%)	0/9 (0%)
Sanchez-Romero (n = 1) [47]	–	–	0/1 (0%)	1/1 (100%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	0/1 (0%)	0/1 (0%)
Souli (n = 6) [43]	3/6 (50%)	3/6 (50%)	5/6 (83.3%)	6/6 (100%)	3/6 (50%)	3/6 (50%)	4/6 (66.7%)	0/6 (0%)	2/6 (33.3%)	2/6 (33.3%)
Viaggi (n = 1) [29]	0/1 (0%)	1/1 (100%)	0/1 (0%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	0/1 (0%)
Virgilio (n = 1) [30]	0/1 (0%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	0/1 (0%)	0/1 (0%)	1/1 (100%)	1/1 (100%)	0/1 (0%)	0/1 (0%)
N = 53	14/39 (35.9%)	22/42 (52.4%)	19/53 (35.8%)	47/53 (88.6%)	39/53 (73.6%)	26/53 (49.1%)	23/53 (43.4%)	16/53 (30.2%)	5/53 (9.4%)	4/53 (7.5%)

PMB polymyxin B, COL colistin, TCN tetracycline, AMG aminoglycoside, CARB carbapenem, FOS fosfomycin, PCN penicillin, FQ fluoroquinolone
^aDual carbapenem therapy used
^bRifampin also administered
^cTrimethoprim–sulfamethoxazole also administered
^dDash indicates information was unavailable

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