BMJ  2004;328 (20 March), doi:10.1136/bmj.328.7441.0-c

Adding amynoglycoside to lactam does not improve results

In patients with neutropenia and sepsis, mortality when lactams and aminoglycosides are used together is no different from lactams used alone, but the risk of adverse effect is increased. Paul and colleagues (p 668) reviewed 64 trials with 7586 patients and found that the combination did not improve survival or reduce superinfection or colonisation rates; nephrotoxicity was more common with combination therapy. The overall quality of the studies was poor, the authors say, and it is of concern that studies comparing different lactams may not detect important harm to patients.

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lactam monotherapy versus lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials

Mical Paul, Ishay Benuri-Silbiger, Karla Soares-Weiser, and Leonard Leibovici
BMJ 2004 328: 668. [Abstract] [Full Text] [PDF]

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