Impact of attaining aggressive vs. conservative PK/PD target on the clinical efficacy of beta-lactams for the treatment of Gram-negative infections in the critically ill patients: a systematic review and meta-analysis

Table 3 Results of meta-analysis for primary and secondary outcomes of attaining aggressive vs. conservative PK/PD targets of beta-lactams in critically ill patients

Outcome	Studies	PK/PD target assessed	No. of patients (Aggressive vs. conservative PK/PD targets)	Odds ratio (95% CI)	Heterogeneity (I²; p value)	Publication bias (p value Egger’s test)
Clinical cure	8	100%fT_{>4–5 x MIC} fC_ss/MIC > 4–5	701 vs. 1172	1.69 (1.15–2.49) p = 0.007	73.8% p = 0.004	0.10
Microbiological failure	3	fC_ss/MIC < 4–5	175 vs. 42	26.08 (8.72–77.95) p < 0.001	0.0% p = 0.66	0.73
Resistance occurrence	3	100%fT_{>4–5 x MIC} fC_ss/MIC > 4–5	269 vs. 96	0.06 (0.01–0.29) p < 0.001	69.7% p = 0.04	0.62
Mortality rate	2	100%fT_{>4 x MIC}	269 vs. 150	0.82 (0.36–1.85) p = 0.63	58.9% p = 0.12	NA
Survival rate	3	100%fT_{>4–5 x MIC}	313 vs. 759	1.15 (0.50–2.66) p = 0.75	66.2% p = 0.05	0.33

CI confidence interval, C_ss steady-state concentration, MIC minimum inhibitory concentration, NA not applicable, PK/PD pharmacokinetic/pharmacodynamic

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