This discrepancy may stem from several factors: (1) Patient and infection complexity: Randomized controlled trial (RCT) populations exhibit high heterogeneity, and the complexity of infections (such as endocarditis and deep-seated abscesses) far exceeds that of standardized laboratory models; (2) Suboptimal dosing regimens: The dosing regimens used in trials may fail to achieve the PK/PD targets required for synergy at the infection site; (3) Adverse events (AEs): The meta-analysis revealed a nonsignificant trend toward greater treatment discontinuation due to AEs in the combination arms, which may have potentially confounded the efficacy assessment.
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Overcoming the drug resistance barrier: progress in fosfomycin combination therapy against multidrug-resistant pathogens.
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