The use of ceftolozane-tazobactam in the treatment of complicated intra-abdominal infections and complicated urinary tract infections—A meta-analysis of randomized controlled trials

• Published in: International journal of antimicrobial agents 2020-02, Vol.55 (2), p.105858-105858, Article 105858
• Main Authors: Cheng, I-Ling, Chen, Yu-Hung, Lai, Chih-Cheng, Tang, Hung-Jen
• Format: Article
• Language: English
• Subjects: ceftolozane-tazobactam; complicated intra-abdominal infections; complicated urinary tract infections
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2019.11.015

•Meta-analysis of ceftolozane-tazobactam in cIAIs and cUTIs•Ceftolozane-tazobactam clinical cure rate similar to comparators in different populations•Ceftolozane-tazobactam microbiological eradication rate for pathogens similar to comparators•Treatment-emergent AEs, serious AEs, drug discontinuation and mortality similar in ceftolozane-tazobactam and comparators•Ceftolozane-tazobactam clinical efficacy as high as that of comparators in cIAIs and cUTIs in adults, and well tolerated The aim of this study was to assess the clinical efficacy and safety of ceftolozane-tazobactam in the treatment of complicated intra-abdominal infections (cIAIs) and complicated urinary tract infections (cUTIs) in adult patients through meta-analysis. PubMed, Embase and Cochrane databases were searched up to June 2019. Only randomized controlled trials (RCTs) that evaluated ceftolozane-tazobactam and comparators for treating cIAIs and cUTIs in adult patients were included. Primary outcome was clinical cure rate; secondary outcomes were clinical failure rate, microbiological eradication rate, and risk of an adverse event (AE). Three RCTs were included. Overall, ceftolozane-tazobactam had a clinical cure rate similar to comparators in the microbiological intent-to-treat (mITT) population (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.43–1.79; I2 = 73%) and in the clinically evaluable (CE) population (OR, 1.22; 95% CI, 0.79–1.88; I2 = 0%). Furthermore, ceftolozane-tazobactam had a similar microbiological eradication rate for pathogens (OR, 1.31; 95% CI, 0.42–4.10; I2 = 37%). There were no significant differences in the risks of treatment-emergent AEs (OR, 1.04; 95% CI, 0.87–1.23; I2 = 0%), serious AEs (OR, 1.16; 95% CI, 0.67–1.99; I2 = 37%), discontinuation of study drug due to an AE (OR, 0.77; 95% CI, 0.17–3.47) and mortality (OR, 1.62; 95% CI, 0.69–3.77, I2 = 0%) between ceftolozane-tazobactam and comparators. The clinical efficacy of ceftolozane-tazobactam is as high as that of comparators in the treatment of cIAIs and cUTIs in adult patients, and this antibiotic is well tolerated.