Efficacy and Safety of Ceftazidime-Avibactam for the Treatment of Carbapenem-Resistant Enterobacteriaceae Bloodstream Infection:A Meta-analysis
10.3870/j.issn.1004-0781.2024.10.004
- VernacularTitle:头孢他啶-阿维巴坦治疗耐碳青霉烯类肠杆菌血流感染的有效性及安全性Meta分析
- Author:
Yuhui CHAI
1
;
Yunyun YANG
;
Jingxia CHEN
Author Information
1. 海军军医大学第一附属医院(上海长海医院)药剂科,上海 200433
- Keywords:
Ceftazidime-avibactam;
Carbapenem-resistant Enterobacteriaceae;
Bloodstream infection;
Systematic evaluation
- From:
Herald of Medicine
2024;43(10):1552-1561
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the efficacy and safety of the ceftazidime-avibactam(CAZ-AVI)regimen versus other regimens for treatment of carbapenem-resistant Enterobacteriaceae(CRE)bloodstream infections,and to provide an evidence-based foundation for drug selection in clinical CRE bloodstream infections.Methods A computerized search was conducted in Pubmed,Embase,Cochrane Library,Web of Science,Wanfang Medical Network,CNKI and China Science and Technology Journal Database for literature on CAZ-AVI for CRE bloodstream infections from the inception of each database up to November 2023.The literature quality evaluation and data extraction were independently performed by two researchers.A meta-analysis was performed using Review Manager 5.3 software.Results A total of 15 English articles and 1 580 patients were included.The results showed that the clinical cure rate[OR=3.32,95% CI=(2.25,4.90),P<0.000 01]and microbial clearance rate[OR=3.00,95% CI=(1.15,7.81),P=0.02]were significantly higher in the CAZ-AVI group than in the control group,and the 28 d/30 d all-cause mortality rate of patients in the CAZ-AVI group was lower than that of the control group[OR=0.38,95% CI=(0.29,0.51),P<0.000 01].The recurrence rates of infection in the two groups were equivalent and statistically non-significant[OR=0.75,95% CI=(0.39,1.42),P=0.37].Subgroup analysis indicated that the CAZ-AVI group had a lower all-cause mortality rate than the tigecycline group[OR=0.20,95% CI=(0.11,0.39),P<0.000 01].In terms of safety,the incidence of adverse events between the two groups was comparable and statistically non-significant[RR=0.47,95% CI=(0.20,1.07),P=0.07].However,the nephrotoxicity was significantly lower in the CAZ-AVI group than in the control group[OR=0.36,95% CI=(0.21,0.64),P=0.000 5].Conclusion Based on the findings of the current study,CAZ-AVI offers potential clinical advantages in the treatment of CRE bloodstream infections by improving clinical cure rates and reducing mortality rates.
