Effect of Cephalosporins on Pneumonia-related Events in ICU Patients: A Meta-analysis

Objective: Pneumonia in ICU patients is a common and serious infection, and cephalosporin antibiotics are widely used in its treatment.However, there is a lack of systematic comprehensive evaluation on the efficacy and safety of cephalosporin antibiotics in ICU patient pneumonia.This study aims to evaluate the efficacy and incidence of adverse events of cephalosporin antibiotics in ICU patient pneumonia through meta-analysis.Methods: English databases (PubMed, Embase, Cochrane Library, Web of Science) were searched from the establishment of each database until August 27, 2023. Randomized controlled trials (RCTs) on the effects of cephalosporin antibiotics on pneumonia-related events in ICU patients were included. The literature screening and data extraction were independently conducted by two researchers, and any discrepancies were resolved by a third party. The treatment group received cephalosporin antibiotics, while the control group received blank control or placebo. Randomized controlled trials on the preventive effects of cephalosporin antibiotics on ICU patient pneumonia and related events were collected according to the inclusion and exclusion criteria. Review Manager 5.4 was used to assess the quality of literature included in the systematic review. Meta-analysis was performed using Stata 15.1 software. The differences in various indicators were presented as relative risk (RR) and 95% confidence interval (CI). Results: A total of 10 relevant RCTs with a total of 2178 patients were included, including 1056 patients in the cephalosporin group and 1122 patients in the control group. The meta-analysis results showed that there was no statistically significant difference in the incidenceof pneumonia events [RR=0.64,95% CI (0.37, 1.10), P=0.051]; incidence of mortality events [RR=1.09,95% CI (0.92, 1.30), P=0.098]; incidence of adverse events [RR=0.75,95% CI (0.56, 1.02), P=0.051]; cure rate of infection [RR=0.96,95% CI (0.88, 1.05), P=0.051]; ICU length of stay [WMD=-2.56,95% CI (-4.67, -1.26), P=0.894]; duration of mechanical ventilation [WMD=-0.95,95% CI (-6.05, 4.14), P=0.033].Conclusion: Cephalosporin antibiotics are comparable to other treatment regimens in reducing the incidence of pneumonia-related events in ICU patients, but further studies with larger sample sizes are needed to provide more evidence.