Evaluation of the efficacy and safety of ceftazidime/avibactam in the treatment of Gram-negative bacterial infections: a systematic review and meta-analysis

International Journal of Antimicrobial Agents
Han ZhongMin Cui

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 (RR = 0.99, 95% CI 0.96-1.02; I2 = 0%) and non-inferior bacterial eradication (RR = 1.04, 95% CI 0.93-1.17; I2 = 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 (RR = 1.61, 95% CI 1.13-2.29) with reduced mortality (RR = 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 bloodstrea...Continue Reading

Citations

Oct 3, 2019·Current Opinion in Infectious Diseases·Antonio VenaMatteo Bassetti
Jun 28, 2019·Frontiers in Public Health·Ilias KaraiskosGaryphallia Poulakou
May 21, 2020·Surgical Infections·Paul M RobbenRoseanne A Ressner
Dec 4, 2020·Expert Review of Anti-infective Therapy·Marios KarvouniarisGaryphallia Poulakou
Nov 13, 2020·Clinical Microbiology Reviews·Dafna YahavLeonard Leibovici
Jan 5, 2021·Current Opinion in Infectious Diseases·Andrew F Shorr, Marya D Zilberberg
Apr 4, 2021·Journal of Clinical Medicine·Erlangga YusufMireille van Westreenen

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