The Efficacy and Safety of Doripenem in the Treatment of Acute Bacterial Infections—A Systemic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

This study aims to assess the efficacy and safety of doripenem on treating patients with acute bacterial infections. The Pubmed, Embase, and Cochrane databases were searched up to April 2019. Only randomized clinical trials comparing doripenem and other comparators for the treatment of acute bacterial infection were included. The primary outcome was the clinical success rate and the secondary outcomes were microbiological eradication rate and risk of adverse events. Eight randomized controlled trials (RCTs) were included. Overall, doripenem had a similar clinical success rate with comparators (odds ratio [OR], 1.15; 95% CI, 0.79–1.66, I2 = 58%). Similar clinical success rates were noted between doripenem and comparators for pneumonia (OR, 0.84; 95% CI, 0.46–1.53, I2 = 72%) and for intra-abdominal infections (OR, 1.00; 95% CI, 0.57–1.72). For complicated urinary tract infection, doripenem was associated with higher success rate than comparators (OR, 1.89, 95% CI, 1.13–3.17, I2 = 0%). The pool analysis comparing doripenem and other carbapenems showed no significant differences between each other (OR, 0.96, 95% CI, 0.59–1.58, I2 = 63%). Doripenem also had a similar microbiological eradication rate with comparators (OR, 1.08; 95% CI, 0.86–1.36, I2 = 0%). Finally, doripenem had a similar risk of treatment-emergent adverse events as comparators (OR, 0.98; 95% CI, 0.83–1.17, I2 = 33%). In conclusion, the clinical efficacy of doripenem is as high as that of the comparator drugs in the treatment of acute bacterial infection; furthermore, this antibiotic is as well tolerated as the comparators.

Doripenem in the Treatment of Patients with Nosocomial Pneumonia: A Meta-Analysis

“…In terms of PA pneumonia, doripenem has a microbiological cure rate, a clinical cure rate, and an all-cause mortality similar to those of comparator antimicrobial agents for the treatment of PA pneumonia. There were only two meta-analyses reported in the literature that explored doripenem therapy for bacterial infections [ 23 , 24 ]. The two meta-analyses also reported that doripenem had a microbiological cure rate, a clinical cure rate, and an all-cause mortality similar to those of comparator antimicrobial agent therapies for bacterial infections.…”

Desenvolvimento De Filmes Oroadesivos Contendo Produtos Naturais Com Atividade Anti-Candida

“…Clinicamente é aprovado para uso em infecção intra-abdominal complicada (IAI), infecção complicada do trato urinário (ITUc) e pielonefrite/pneumonia associadas a assistência da saúde (PAH). Um estudo recentemente demonstrou que esse antimicrobiano foi duas vezes mais potente in vitro quando comparado ao Imipenem e meropenem (LAI et al, 2019).…”

Doripenem for treating nosocomial pneumonia and ventilator-associated pneumonia

“…By contrast with the study by Kollef and colleagues, 2 which was unable to show non-inferiority for doripenem, the other two studies 3,4 compared doripenem with comparators over a similar treatment duration and reported noninferiority for doripenem. Doripenem was most commonly used for treating pneumonia in a surveillance study, 5 and a meta-analysis up to April, 2019, 6 showed that doripenem was non-inferior to comparators in the treatment of nosocomial pneumonia and ventilator-associated pneumonia. Therefore, we wonder whether doripenem can achieve noninferior efficacy if it can be used for the same duration as the comparator.…”

“…Mechanically ventilated patients are generally critically ill, and thus might have augmented renal clearance or other factors affecting antimicrobial pharmacokinetics. 6 This can lead to insufficient drug concentrations at the infection site, compounded by the greater prevalence of pathogens with higher minimum inhibitory concentrations in the intensivecare unit. 6,7 Under-dosing, especially in ventilated patients, has been suggested as a contributing factor in several trials unable to show…”