The Effect of Antibiotics on the Eradication of Multidrug-Resistant Organisms in Intestinal Carriers—A Systematic Review with Meta-Analysis

Author:

Knudsen Maja Johanne Søndergaard1,Rubin Ingrid Maria Cecilia1ORCID,Petersen Andreas Munk123ORCID

Affiliation:

1. Department of Clinical Microbiology, Copenhagen University Hospital–Amager and Hvidovre, 2650 Hvidovre, Denmark

2. Gastrounit, Medical Section, Copenhagen University Hospital-Amager and Hvidovre, 2650 Hvidovre, Denmark

3. Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark

Abstract

Objectives: The aim of this systematic review was to investigate the effect of antibiotics on the eradication of multidrug-resistant organisms (MRO) in intestinal carriers. We defined multidrug-resistant organisms as vancomycin-resistant Enterococcus faecium (VREfm), and multidrug-resistant Gram-negative Enterobacterales. Methods: We searched the EMBASE, Cochrane Central, and PubMed databases from inception to medio November 2023. We included randomised and controlled clinical trials (RCTs), that investigated the effect of antibiotics on the eradication of multidrug-resistant organisms in intestinal carriers. Finally, we performed a meta-analysis. Results: We included five RTCs in the systematic review. In four studies an effect of antibiotics on the eradication of MRO was shown at the end of intervention, but it was not sustained at follow-up. In the fifth study, the effect at the end of intervention was not reported, and there was no observed effect of the intervention at follow-up. We included four studies in the meta-analysis, and it suggests an effect of antibiotics on the eradication of MRO in intestinal carriers at the end of follow-up with a p-value of 0.04 (95% confidence interval 1.02–1.95). None of the studies reported a significant increase in resistance to the study drug. Gastrointestinal disorders were the most frequent non-severe adverse event. Conclusions: The effect of antibiotics on the eradication of multidrug-resistant organisms in intestinal carriers was not statistically significant in any of the five included studies; however, we found a significant effect in the pooled meta-analysis. As the confidence interval is large, we cannot determine the clinical importance of this finding, and it should be further investigated.

Publisher

MDPI AG

Reference37 articles.

1. Association between vancomycin-resistant Enterococcus faecium colonization and subsequent infection: A retrospective WGS study;Rubin;J. Antimicrob. Chemother.,2020

2. A multicentre cohort study on colonization and infection with ESBL-producing Enterobacteriaceae in high-risk patients with haematological malignancies;Vehreschild;J. Antimicrob. Chemother.,2014

3. WHO, and ECDC (2023). Antimicrobial Resistance Surveillance in Europe 2023–2021 Data, ECDC.

4. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis;Murray;Lancet,2022

5. O’Neill, J. (2016). Tackling Drug-Resistant Infections Globally: Final Report and Recommendations, AMR Review. Available online: https://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3