Meta-analysis of Clinical Outcomes Using Ceftazidime/Avibactam, Ceftolozane/Tazobactam, and Meropenem/Vaborbactam for the Treatment of Multidrug-Resistant Gram-Negative Infections

Abstract

Ceftolozane-tazobactam (C/T), Ceftazidime-avibactam (C/A), and Meropenem/vaborbactam (M/V) are new beta-lactam/beta-lactamase combination antibiotics commonly used to treat multi-drug resistant Pseudomonas aeruginosa (MDRPA) and carbapenem-resistant Enterobacteriaceae (CRE) infections. This review reports the clinical success rates for C/T, C/A., and M/V. PubMed and EMBASE were searched from January 1 st, 2012 through September 2 nd, 2020 for publications detailing use of C/T, C/A, and M/V. Meta-analysis determined the pooled effectiveness of C/T, C/A, and M/V. The literature search returned 1,950 publications, 29 publications representing 1,620 patients were retained. Pneumonia was the predominant infection type (49.8%). MDRPA was the major pathogen treated (65.3%). The pooled clinical success rate was 73.3% (95% CI 68.9%-77.5%). C/T, C/A, or M/V resistance was reported in 8.9% of the population. These antibiotics had a high clinical success rate in patients with complicated infections and limited treatment options. Larger studies comparing C/T, C/A, and M/V against other antibiotic regimens are needed.

Uptake in newly approved antibiotics prescribed to patients with carbapenem-resistant Enterobacterales (CRE)

“…8 A meta-analysis that evaluated the use of ceftazidime-avibactam in patients with MDR gram-negative infections found the pooled clinical success rate to be 73.3%, similar to polymyxins (66%-79%). 9 This study had several limitations. Therapies included in this study could have been used for different organisms, which may have overestimated true utilization rates of these antibiotics for CRE.…”

Evaluating the clinical effectiveness of new beta-lactam/beta-lactamase inhibitor combination antibiotics: A systematic literature review and meta-analysis

“…A meta-analysis of 29 studies evaluating C/T, C/A, and M/V, the pooled clinical success rates for those antibiotics was 73.3% (95% CI, 68.9%-77.5%). 39 However, that analysis did not include studies with a comparator group and therefore could not analyze the performance of the new combination antibiotics compared to older therapies. 39 Additionally, the clinical effectiveness of I/R was not included in that analysis.…”

“…39 However, that analysis did not include studies with a comparator group and therefore could not analyze the performance of the new combination antibiotics compared to older therapies. 39 Additionally, the clinical effectiveness of I/R was not included in that analysis. A review of MDRGNO bloodstream infections found a decrease in 30-day mortality associated with C/A use.…”

[Et3NH][HSO4] catalyzed solvent‐free synthesis of new 1,2,3‐triazolidene‐indolinone derivatives

“…The triazole-based anticancer agent [13] carboxyamidotriazole (CAI) 2 is under clinical trials (Phase III). Cefatrizine 3 and tazobactam 4 are among the most prescribed antibiotics; [14] tert-butyldimethylsilyl-spiroaminooxathioledioxide (TSAO) 5 is potential anti-HIV reverse transcriptase inhibitor. [15] Rufinamide 6, a popular anticonvulsant, is currently used to treat seizure disorder.…”