Objective  To evaluate the efficacy of biapenem combined with levofloxacin in the treatment of severe pneumonia caused by multi-drug resistant pseudomonas aeruginosa (MDR-PA), and to provide evidence-based basis for the treatment of severe pneumonia caused by MDR-PA.

Methods  The relevant literature was searched in CNKI, VIP, WanFang Data, Chinese Medical Journal Full-Text database, PubMed, The Cochrane Library and Embase database. The quality of included articles were evaluated. RevMan 5.4 software was used for a Meta-analysis.

Results  A total of 6 articles including 622 subjects, 314 in the observation group and 308 in the control group were included in this study. The results of Meta-analysis showed that the total effective rate of 93.0% in the observation group was significantly higher than that of 75.3% in the control group [OR=4.34, 95%CI(2.62, 7.19), P<0.001]. The observation group had a shorter time in the disappearance of pulmonary rales [MD=-3.03, 95%CI(-3.82, -2.24), P<0.001] and chest radiograph shadow resolution [MD=-3.42, 95%CI (-3.80, -3.05), P<0.001] than those in the control group. The observation group was superior to the control group in reducing white blood cell count (WBC) [SMD=-1.56, 95%CI(-1.79, -1.34), P<0.001], procalcitonin (PCT) [SMD=-1.28, 95%CI(-1.77, -0.79), P<0.001], and C-reactive protein (CRP) [SMD=-1.19, 95%CI(-1.95, -0.44), P=0.002].

Conclusion  The combination of biapenem and levofloxacin has shown promising clinical efficacy in the treatment of severe pneumonia caused by MDR-PA. Due to the limitation of the number and quality of included studies, large sample and high-quality studies are needed for further confirmation.

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