Colistin plus meropenem versus colistin alone for invasive infections caused by carbapenem-resistant Acinetobacter baumannii: a rapid systematic review of randomized controlled trials using Bayesian meta-analysis.

Review question / Objective: What is the benefit stemming from meropenem add-on treatment to colistin against Carbapenem-Resistant strains of Acinetobacter baumannii? Condition being studied: Invasive infections caused by extensively drug-resistant (XDR) Acinetobacter baumannii, specifically carbapenem-resistant Acinetobacter baumannii (CRAB), are associated with high mortality above 50%, especially in critically ill patients. Often colistin is the only active agent in vitro and, although its safety issues, remains the cornerstone of therapy. Nevertheless, considering the relevant mortality rate when resorting to colistin alone, an intriguing idea is to exploit the potent in vitro synergy of colistin when combined with carbapenems.