Aminoglycosides in Combination Therapy with ß-Lactam Antibiotics for Staphylococcus aureus Endocarditis: A Systematic Review
Bibliographic record
Abstract
ABSTRACT Background: There is no consensus as to whether aminoglycosides have a role in combination with s-lactams for the treatment of Staphylococcus aureus endocarditis. Objective: To review the literature pertaining to the use of aminoglycosides in combination with s-lactams for S. aureus endocarditis. Methods: A literature search was conducted in PubMed, EMBASE, and the Cochrane Database of Systematic Reviews (with various time frames, depending on the database). The search terms were “aminoglycoside”, “gentamicin”, “tobramycin”, “amikacin”, “netilmicin”, “streptomycin”, “staphylococcal”, and “endocarditis”; restrictions were set to identify only English-language articles describing research involving human subjects. The reference lists of all relevant articles identified in these searches were reviewed manually. All published reports of an aminoglycoside being given in combination with a s-lactam for the treatment of S. aureus endocarditis were reviewed to assess whether the results favoured combination therapy. A survey of the use of therapeutic drug monitoring for aminoglycosides was also conducted. Results: Twelve relevant articles were identified. Seven of the articles were categorized as presenting the highest quality of evidence (levels I and II), and only 1 of these favoured combination therapy, the outcome being time to clinical improvement in the subpopulation of intravenous drug users. The 5 articles with lower-quality (level III) evidence favoured the combination regimens but did not make comparisons with s-lactam monotherapy. Only 2 articles described therapeutic drug monitoring techniques with respect to aminoglycoside therapy. Conclusion: Current evidence does not support the use of aminoglycosides for the treatment of S. aureus endocarditis. RESUME Historique : Il n’existe aucun consensus sur le role possible des aminosides administres en association avec des s-lactamines dans le traitement de l’endocardite a Staphylococcus aureus. Objectif : Passer en revue la litterature actuelle sur l’emploi des aminosides en association avec des s-lactamines dans le traitement de l’endocardite a S. aureus. Methodes : Une recherche bibliographique a ete effectuee dans les bases de donnees PubMed, EMBASE et Cochrane Database of Systematic Reviews (sur diverses periodes, selon la base de donnees). Les termes utilises pour la recherche etaient : « aminoside », « gentamicine », « tobramycine », « amikacine », « netilmicine », «streptomycine », «staphylocoque » et « endocardite »; la recherche etait limitee a des articles en anglais decrivant des etudes avec des humains. Un examen des bibliographies de tous les articles pertinents ainsi recenses a aussi ete realise. Tous les rapports publies faisant etat de l’emploi d’un aminoside en association avec une s-lactamine dans le traitement de l’endocardite a S. aureus ont ete examines pour evaluer dans quelle mesure les resultats privilegiaient le traitement d’association. On a egalement examine si on avait eu recours a la surveillance pharmacocinetique des aminosides. Resultats : Douze articles pertinents ont ete recenses. Sept de ces articles ont ete classes comme presentant des donnees probantes de la plus haute qualite (niveaux I et II), et un seul d’entre eux privilegiait le traitement d’association, le parametre d’evaluation etant le delai d’obtention d’une amelioration clinique dans la sous-population des usagers de drogue par voie intraveineuse. Les cinq articles presentant des donnees probantes de plus faible qualite (niveau III) privilegiaient le traitement d’association, mais ne faisaient aucune comparaison avec le traitement par une s-lactamine en monotherapie. Seulement deux articles ont decrit des methodes de surveillance pharmacocinetique des aminosides. Conclusion : Les donnees actuelles ne corroborent pas l’emploi des aminosides dans le traitement de l’endocardite a S. aureus.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.031 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.010 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".