Efficacy, safety, and economics of ertapenem in the treatment of infectious diseases: a rapid health technology assessment
10.3760/cma.j.cn114015-20240129-00070
- VernacularTitle:厄他培南治疗感染性疾病有效性、安全性和经济性的快速卫生技术评估
- Author:
Yinpeng QIN
1
;
Chao WANG
1
;
Ruixia ZHANG
1
;
Yuanyuan GUO
1
;
Yude QIAN
1
;
Yi ZHANG
1
Author Information
1. 天津市第一中心医院药学部，天津 300192
- Publication Type:Journal Article
- Keywords:
Carbapenems;
Infection;
Efficacy;
Safety;
Economyics;
Health technology assessment;
Ertapenem
- From:
Adverse Drug Reactions Journal
2024;26(6):347-354
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy, safety, and economics of ertapenem in the treatment of infectious diseases by means of rapid health technology assessment.Methods:The relevant databases and health technology assessment websites (up to July 31, 2023) were searched to collect the meta-analyses and economic literature on the efficacy, safety, and economics of ertapenem and other antibacterial drugs in the treatment of infectious diseases. The quality of meta-analyses and economic researches were evaluated by a measurement tool to assess systematic reviews and consolidated health economic evaluation reporting standards, respectively. The patients were divided into ertapenem group and control group (using other antibacterial drugs). The outcome indicators of meta-analysis (clinical cure rate, bacterial clearance rate) and the incidence of adverse reactions were compared between the 2 groups. The economic research were cost-effectiveness analysis and cost-consequence analysis. The relevant results were described qualitatively.Results:A total of 13 literature were enrolled, including 7 systematic reviews/meta-analyses (4 of high-quality, 3 of medium quality) and 6 pharmacoeconomics literature (4 of high quality, 2 of medium quality). There were no significant differences on the clinical cure rate and bacterial clearance rate for complex abdominal infection, community-acquired pneumonia, complex skin and appendage infection between the ertapenem group and the control group (all P>0.05). The clinical cure rate of severe diabetic foot infection in the ertapenem group was lower than that in the piperacillin sodium and tazobactam sodium group [91.5% (119/130) vs. 97.2% (139/143), P=0.04]. The bacterial clearance rate of complicated urinary tract infection in the ertapenem group was higher than that in the ceftriaxone group [98.71% (305/309) vs. 95.45% (273/286), P=0.03]. The incidence of adverse reactions (elevated transaminase and alkaline phosphatase or elevated platelet count) in patients with complex abdominal infection in the ertapenem group was higher than that in the control group [8.96% (68/759) vs. 6.49 %(50/771), P<0.05]. The incidence of adverse reactions after ertapenem treatment for complex infections (community-acquired pneumonia, complicated urinary tract infection and complex abdominal infection) was higher than that in ceftriaxone treatment with or without metronidazole group [10.62% (163/1 535) vs. 7.89% (91/1 153), P=0.02]. The incidence of diarrhea in patients with diabetic foot infection in the ertapenem group was lower than that in the piperacillin sodium and tazobactam sodium group [8.14% (24/295) vs. 14.09% (41/291), P=0.02]. It was more cost-effective using ertapenem than using piperacillin sodium and tazobactam sodium, ceftriaxone in treatment of complex abdominal infection, diabetic foot infection, complicated urinary tract infection, community-acquired pneumonia, etc. Conclusions:The efficacy of ertapenem in treatment for complex abdominal infection, community-acquired pneumonia and complex skin and appendage infection are similar to that of commonly used antibiotics in clinic, and the bacterial clearance rate in treatment for complicated urinary tract infection was higher than that of ceftriaxone. There are differences in the incidence of adverse reactions in complex abdominal infection, community-acquired pneumonia, complicated urinary tract infection, and diabetic foot infection between the 2 groups. The use of ertapenem can reduce the cost of drug treatment and has economic advantages.
