Efficacy of Tigecycline Combined with Sulbactam to Acinetobacter Baumannii Infection: A Meta-analysis

OBJECTIVE To evaluate the efficacy of tigecycline combined with sulbactam in the treatment of multidrug/extensively drug resistant Acinetobacter baumannii infection. METHODS Systematic search was performed of the CNKI, Wangfang Data, CBM, PubMed, The Cochrane Library, Web of science, Embase from inception to July 1, 2018. The retrieval method was subject headings combined with free words search. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software. RESULTS A total of 1 062 articles were retrieved, and 46 articles met the criteria were selected. The results of meta-analysis showed that for overall efficacy and bacterial clearance, tigacycline combined with sulbactam has more advantages than tigacycline alone or sulbactam aloneOR=3.90, 95%CI(3.25, 4.68), P<0.000 01,OR=3.29, 95%CI(2.76, 3.92), P<0.000 01; for adverse reactions, combination therapy didn't increase the incidenceOR=0.87, 95%CI(0.67, 1.14), P=0.31. Subgroup analysis showed that the combined with sulbactam could reduce the incidence of adverse reactions vs tigacycline aloneOR=0.51, 95%CI (0.28, 0.93), P=0.03. CONCLUSION Tigacycline combined with sulbactam is superior to tigacycline alone or sulbactam alone in the treatment of multidrug/extensively drug resistant Acinetobacter baumannii infections.