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Ceftazidime-Avibactam Combination Therapy Compared to Ceftazidime-Avibactam Monotherapy for the Treatment of Severe Infections Due to Carbapenem-Resistant Pathogens: A Systematic Review and Network Meta-Analysis
- Source :
- Antibiotics, Vol 9, Iss 388, p 388 (2020), Antibiotics, Volume 9, Issue 7
- Publication Year :
- 2020
-
Abstract
- Ceftazidime-avibactam (CZA) is a novel beta-lactam beta-lactamase inhibitor combination approved for the treatment of complicated urinary tract infections, complicated intra-abdominal infections, and for hospital-acquired/ventilator-associated pneumonia. The aim of this systematic review (PROSPERO registration number: CRD42019128927) was to evaluate the effectiveness of CZA combination therapy versus CZA monotherapy in the treatment of severe infections. The databases included in the search, until February 12th, 2020, were MEDLINE by PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials. We included both randomized controlled trials (RCTs) and non-randomized studies published in peer-reviewed journals and in the English language. The primary outcome was all-cause mortality (longest follow-up) evaluated in patients with the diagnosis of infection with at least one pathogen<br />secondary outcomes were clinical and microbiological improvement/cure. Thirteen studies were included in the qualitative synthesis: 7 RCTs and 6 retrospective studies All the six retrospective studies identified carbapenamase-producing Enterobacteriaceae (CRE) as the cause of infection and for this reason were included in the network meta-analysis (NMA)<br />the quality of the studies, assessed using the New Castle-Ottawa Scale, was moderate-high. In all the six retrospective studies included in the NMA, CZA was used in large part for off-label indications (mostly blood stream infections: 80&ndash<br />100% of patients included). No difference in mortality rate was observed in patients undergoing CZA combination therapy compared to CZA monotherapy [n = 503 patients, direct evidence OR: 0.96, 95% CI: 0.65&ndash<br />1.41].
- Subjects :
- 0301 basic medicine
Carbapenem-resistant enterobacteriaceae
Biochemistry
law.invention
sepsis
Ceftazidime‐avibactam
0302 clinical medicine
Randomized controlled trial
systematic review
law
Pharmacology (medical)
030212 general & internal medicine
General Pharmacology, Toxicology and Pharmaceutics
network meta-analysis
ceftazidime-avibactam
Anti‐infective agent
network meta-analysi
Infectious Diseases
carbapenem-resistant Enterobacteriaceae
Meta-analysis
β-lactamase inhibitors
sepsi
medicine.drug
Microbiology (medical)
medicine.medical_specialty
Combination therapy
030106 microbiology
MEDLINE
β‐lactamase inhibitors
Microbiology
Article
03 medical and health sciences
Carbapenem‐resistant Enterobacteriaceae
multidrug resistance
Internal medicine
medicine
anti-infective agent
bacteremia
business.industry
lcsh:RM1-950
Retrospective cohort study
Ceftazidime/avibactam
medicine.disease
infection
lcsh:Therapeutics. Pharmacology
Bacteremia
anti-infective agents
business
Network meta‐analysi
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Antibiotics, Vol 9, Iss 388, p 388 (2020), Antibiotics, Volume 9, Issue 7
- Accession number :
- edsair.doi.dedup.....1cfb1078de002648bcbf2fa8d29c71bb