Table 3_Clinical outcomes and adverse events associated with intravenous polymyxin-containing therapy in hospitalized children with resistant Gram-negative infections: a systematic review and meta-analysis.docx

Background<p>Intravenous polymyxins remain salvage agents for resistant Gram-negative infections in children, but pediatric evidence on clinical outcomes and toxicity is fragmented.</p>Methods<p>We systematically searched PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Wanfang Data, SinoMed, and VIP from inception to 31 January 2025. Eligible studies reported intravenous polymyxin-containing therapy in hospitalized pediatric patients with documented or suspected resistant Gram-negative infections.

Random-effects single-arm meta-analyses were used to estimate pooled outcome proportions.</p>Results<p>Twenty-four studies comprising 1,152 reported patients or treatment units were included, most of which were single-arm observational studies. The pooled proportions were 22% [95% confidence interval (CI) 16%–27%] for all-cause mortality, 14% (95% CI 11%–17%) for infection-related mortality, 65% (95% CI 58%–72%) for clinical improvement, 13% (95% CI 9%–17%) for overall adverse events, and 10% (95% CI 7%–14%) for nephrotoxicity.