Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
11008458 | International Journal of Antimicrobial Agents | 2018 | 8 Pages |
Abstract
Data on the efficacy and safety of ceftazidime/avibactam (CAZ-AVI) are limited. A systematic review and meta-analysis was conducted to clarify the role of CAZ-AVI for patients with serious Gram-negative bacterial infections. The PubMed, EMBASE and Cochrane Library databases were searched for randomised controlled trials (RCTs) and cohort studies involving CAZ-AVI. Summary risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a fixed- or random-effects model. Twelve articles (4951 patients) were included, consisting of nine RCTs and three observational studies comparing CAZ-AVI with other regimens, e.g. carbapenems or colistin. CAZ-AVI showed a comparable clinical response (RRâ¯=â¯0.99, 95% CI 0.96-1.02; I2â¯=â¯0%) and non-inferior bacterial eradication (RRâ¯=â¯1.04, 95% CI 0.93-1.17; I2â¯=â¯79.1%) to carbapenems. No significant difference was detected between groups regarding mortality and adverse events. Moreover, subgroup analyses demonstrated that CAZ-AVI improved the clinical response (RRâ¯=â¯1.61, 95% CI 1.13-2.29) with reduced mortality (RRâ¯=â¯0.29, 95% CI 0.13-0.63) in patients infected by carbapenem-resistant Enterobacteriaceae versus comparators. Likewise, CAZ-AVI improved the clinical cure rate of bloodstream infections (RRâ¯=â¯2.11, 95% CI 1.54-2.88). An improved ability of CAZ-AVI in microbiological eradication was also detected in patients with complicated urinary tract infections (RRâ¯=â¯1.13, 95% CI 1.05-1.21). CAZ-AVI exhibited comparable efficacy and safety with carbapenems. Therefore, this agent might be a potential powerful agent for patients with serious Gram-negative bacterial infections.
Keywords
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Authors
Han Zhong, Xian-Yuan Zhao, Zai-Li Zhang, Zhi-Chun Gu, Chi Zhang, Yuan Gao, Min Cui,