OBJECTIVES: Antibiotics are commonly classified into bactericidal and bacteriostatic agents based on their antimicrobial action. We aimed to assess whether this distinction is clinically relevant. METHODS: OVID MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL) and relevant references and conference proceedings using the Web of Science and Scopus databases were searched for randomized controlled trials comparing bactericidal with bacteriostatic antibiotics for treatment of severe @entity281 . Main outcome measures were clinical cure rates and overall mortality. Abstracts of studies selected in the database search were screened by one reviewer; full-text screening and data extraction were performed by three independent reviewers. RESULTS: Thirty-three studies were included. Approximately half of @entity1 were treated with bacteriostatic monotherapy. Infections covered were @entity55 (n=13), skin and soft tissue @entity281 (n=8), @entity1320 (n=4) and others (n=8). Neither clinical cure rates [risk ratio (RR), 0.99; 95% CI, 0.97-1.01; P=0.11] nor mortality rates (RR, 0.91; 95% CI, 0.76-1.08; P=0.28) were different between @entity1 treated with bactericidal drugs and those treated with bacteriostatic drugs. Subgroup analyses showed a benefit for clinical cure rates associated with linezolid and increased mortality associated with @entity9001 . In meta-regression, clinical cure rates remained higher in @entity1 treated with @entity5136 (P=0.01); @entity9001 displayed a close to significant association with increased mortality (P=0.05) if compared with other bacteriostatic agents. CONCLUSIONS: The categorization of antibiotics into bacteriostatic and bactericidal is unlikely to be relevant in clinical practice if used for @entity1320 , skin and soft tissue @entity281 and @entity55 . Because we were not able to include studies on @entity693 , @entity884 or @entity1398 , no conclusion regarding these diseases can be drawn.

Bacteriostatic versus bactericidal antibiotics for XXXX with serious bacterial infections: systematic review and meta-analysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5136 :: ('MESH:C098010', 'Chemical') :: ['linezolid'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity693 :: ('MESH:D008581', 'Disease') :: ['meningitis'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infections'] @entity1398 :: ('MESH:D009503', 'Disease') :: ['neutropenia'] @entity1320 :: ('MESH:D059413', 'Disease') :: ['intra-abdominal infections', 'abdominal infections'] @entity9001 :: ('MESH:C119092', 'Chemical') :: ['tigecycline'] @entity884 :: ('MESH:D004696', 'Disease') :: ['endocarditis']
@entity1 :: (9606,Species) :: ['patients']
