Novel β-lactam/β-lactamase inhibitors versus alternative antibiotics for the treatment of complicated intra-abdominal infection and complicated urinary tract infection: a meta-analysis of randomized controlled trials. Issue 2 (1st February 2018)

• Record Type: Journal Article
• Authors: Chen, Mengmeng; Zhang, Minjie; Huang, Peixian; Lin, Qiongyu; Sun, Cheng; Zeng, Hongke; Deng, Yiyu
• Is Part Of: Expert review of anti-infective therapy. Volume 16:Issue 2(2018)
• Page Start: 111
• Page End: 120
• Publication Date: 2018-02-01
• Subjects: Novel β-lactam/β-lactamase inhibitors -- ceftazidime/avibactam -- ceftolozane/tazobactam -- carbapenem -- complicated urinary tract infection -- complicated intra-abdominal infection; Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1080/14787210.2018.1429912
• Languages: English
• ISSNs: 1478-7210

Abstract

ABSTRACT: Introduction : The aim of this study is to compare the efficacy and safety of novelBL/BLIs with alternative antibiotics for the treatment of cIAI and cUTI. Area covered : We performed a systematic review and meta-analysis of all randomized controlled trials comparing novel BL/BLIs with other antibiotics for the treatment of cIAI and cUTI. The primary outcome included clinical and microbiological treatment success. Expert commentary : We found that novel BL/BLIs obtained a similar clinical outcome with other antibiotics in CE population (OR = 1.07, 95%CI = (0.80, 1.44), P = 0.64). However, novel BL/BLIs had better clinical treatment success in the cUTI subgroup (OR = 2.14, 95%CI = (1.06, 4.31), P = 0.03). Furthermore, novel BL/BLIs achieved significant microbiological treatment success in patie nts with cUTI (OR = 1.70, 95%CI = (1.29, 2.25), P = 0.0002) and had higher eradication rates for Gram-negative pathogens (OR = 1.82, 95%CI = (1.26, 2.64), P = 0.001) including E.coli and K.pneumoniae . No difference was observed concerning the incidence of mortality and adverse events between the two groups. Therefore, we concluded that novel BL/BLIs are not inferior to other available antibiotics for the treatment of cIAI, and they have advantages in patients with cUTI. Simultaneously, they are sensitive to Gram-negative pathogens, especially for E.coli and K.pneumoniae .