AUTHOR=Wang Lei , Tong Xiang , Huang Jizhen , Zhang Li , Wang Dongguang , Wu Man , Liu Tao , Fan Hong 

TITLE=Triple Versus Double Therapy for the Treatment of Severe Infections Caused by Carbapenem-Resistant Enterobacteriaceae: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 10 - 2019

YEAR=2020

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2019.01673

DOI=10.3389/fphar.2019.01673

ISSN=1663-9812

ABSTRACT=Introduction: The role of combination treatment in the management of carbapenem-resistant Enterobacteriaceae infections (CRE) is still unclear. There have been no meta-analysis comparing the efficiency of triple therapy in treating CRE infections with that of double therapy. In this perspective, we conducted a meta-analysis to clarify whether triple therapy is superior to double therapy in treating patients with CRE infections. 
Methods: We performed a systematic review, using PubMed and Embase without any restrictions until June 2019. Risk ratio (RR) with 95% CI were pooled to evaluate the effect of intervention. 
Results: A total of 32 studies were identified. Pooled analysis showed that triple therapy was not associated with a reduced mortality compared with double therapy (HR 1.07 95 % CI 0.91-1.25, P = 0.4). 
Conclusions: This meta-analysis suggests that double therapy is noninferior to triple therapy in the treatment of patients with CRE infections, although the quality of evidence in this systematic review is generally low based on current literatures.