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Are there differences between ceftolozane/tazobactam and ceftazidime/avibactam in treating patients with complicated abdominal infections? Evidence from clinical trials.
Avilés Martínez, M C; Alfaro Martínez, J J; Blanch Sancho, J J; Solís García Del Pozo, J.
Afiliación
  • Avilés Martínez MC; Department of Internal Medicine, Albacete University Hospital, Albacete, Spain.
  • Alfaro Martínez JJ; Department of Endocrinology and Nutrition, Albacete University Hospital, Albacete, Spain.
  • Blanch Sancho JJ; Infectious Diseases Unit, Department of Internal Medicine, Albacete University Hospital, Albacete, Spain.
  • Solís García Del Pozo J; Infectious Diseases Unit, Department of Internal Medicine, Albacete University Hospital, Albacete, Spain.
J Chemother ; 34(7): 419-426, 2022 Nov.
Article en En | MEDLINE | ID: mdl-35550007
Ceftolozane/tazobactam (C/T) and ceftazidime/avibactam (CZA) are new possibilities of antimicrobial treatment that combined a ß-lactam with a ß-lactamase inhibitor. The United States (US) and European regulatory agencies approved their clinical use in adults with complicated intra-abdominal infections. This study aims to know if one of the two antibiotics obtain better efficacy in adults with complicated intra-abdominal infections and by specific pathogens such as P. aeruginosa or E. coli. A search of all trials in MEDLINE, Scopus, and Web of Science comparing a C/T or CZA based antimicrobial regimen with other treatments in patients with intraabdominal infections until August 2021 was performed. To make indirect comparisons, we used a frequentist approach using the R package netmeta.The effects have been expressed through the relative risk (RR) with its confidence interval. Considering the clinical cure and failure rates between the different trial populations (mMITT, CE, ME) and the mortality at the end of the study, we have not found significant differences between CZA and C/T. In the case of Pseudomonas, the RR of treatment failure between these two antibiotics is 1 (95% CI 0.55-1.18). In the case of E. Coli, although it seems that CZA would have a worse result than C/T, differences did not reach statistical significance (RR1.06; 95% CI 0.9-1.14). In conclusion, we have not found statistically significant differences between ceftolozane-tazobactam and ceftazidime-avibactam in treating cIAI. In regards to E. Coli, our results do not reach significance, but it would be possible that C/T and meropenem had better results than CZA. Perhaps new trials would allow a better profile of the role in different types of patients or infections caused by specific microorganisms in the future.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Pseudomonas / Infecciones Intraabdominales Tipo de estudio: Etiology_studies / Systematic_reviews Límite: Adult / Humans Idioma: En Revista: J Chemother Asunto de la revista: ANTINEOPLASICOS / TERAPIA POR MEDICAMENTOS Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por Pseudomonas / Infecciones Intraabdominales Tipo de estudio: Etiology_studies / Systematic_reviews Límite: Adult / Humans Idioma: En Revista: J Chemother Asunto de la revista: ANTINEOPLASICOS / TERAPIA POR MEDICAMENTOS Año: 2022 Tipo del documento: Article País de afiliación: España Pais de publicación: Reino Unido