A systematic review 1 including 19 studies with a total of 3 201 subjects was abstracted in DARE. The failure rate in patients treated with imipenem-cilastatin was on average lower than that in patients treated with a regimen containing an aminoglycoside (26% vs 31%, OR 0.77, 95% CI 0.61 to 0.98) and it was also lower than that in patients treated with a regimen that did not include an aminoglycoside (27% vs 33%, OR 0.67, 95% 0.54 to 0.84).
Comment: The quality of evidence is downgraded by severe study limitations. The result should be interpreted with caution as the definion of clinical failure was not consistent across studies and its diagnosis may depend on subjective judgment. The outcome was not measured blindly in any of the studies, and very few analyses were performed on an intention-to-treat basis.
Primary/Secondary Keywords