Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis
Introduction: Ceftazidime-avibactam (CAZ-AVI) is a combination of the third-generation cephalosporin ceftazidime and the novel, non-β-lactam β-lactamase inhibitor avibactam that is approved for the treatment of pediatric (≥ 3 months) and adult patients with complicated infections including hospital-...
| Autores: | ; ; ; ; ; |
|---|---|
| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universitat Pompeu Fabra |
| Repositorio: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:repositori.upf.edu:10230/60757 |
| Acceso en línea: | http://hdl.handle.net/10230/60757 http://dx.doi.org/10.1007/s40121-024-00999-y |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | Bacteremia Ceftazidime-avibactam Clinical cure Hospital-associated pneumonia Mortality Nosocomial pneumonia Ventilator-associated pneumonia |
| _version_ | 1878730552098422784 |
|---|---|
| author | Shields, Ryan K. |
| author2 | Horcajada Gallego, Juan Pablo Kamat, Shweta Irani, Paurus M. Tawadrous, Margaret Welte, Tobias |
| author2_role | author author author author author |
| author_browse | Horcajada Gallego, Juan Pablo Irani, Paurus M. Kamat, Shweta Shields, Ryan K. Tawadrous, Margaret Welte, Tobias |
| author_facet | Shields, Ryan K. Horcajada Gallego, Juan Pablo Kamat, Shweta Irani, Paurus M. Tawadrous, Margaret Welte, Tobias |
| author_role | author |
| collection | Repositorio Digital de la UPF |
| description | Introduction: Ceftazidime-avibactam (CAZ-AVI) is a combination of the third-generation cephalosporin ceftazidime and the novel, non-β-lactam β-lactamase inhibitor avibactam that is approved for the treatment of pediatric (≥ 3 months) and adult patients with complicated infections including hospital-acquired and ventilator-associated pneumonia (HAP/VAP), and bacteremia. This systematic literature review and meta-analysis (PROSPERO registration: CRD42022362856) aimed to provide a quantitative and qualitative synthesis to evaluate the effectiveness of CAZ-AVI in treating adult patients with bacteremia or nosocomial pneumonia caused by carbapenem-resistant Enterobacterales (non metallo-β-lactamase-producing strains) and multi-drug resistant (MDR) Pseudomonas aeruginosa infections. Methods: The databases included in the search, until November 7, 2022, were Embase and PubMed. A total of 24 studies (retrospective: 22, prospective: 2) with separate outcomes for patients with bacteremia or pneumonia were included. Results: The outcomes assessed were all-cause mortality, clinical cure, and microbiological cure. Qualitative (24 studies) and quantitative (8/24 studies) syntheses were performed. The quality of the studies was assessed using the MINORS checklist and the overall risk of bias was moderate to high. Conclusions: In studies included in the meta-analysis, lower all-cause mortality for patients with bacteremia (OR = 0.30, 95% CI 0.19-0.46) and improved rates of clinical cure for patients with bacteremia (OR = 4.90, 95% CI 2.60-9.23) and nosocomial pneumonia (OR = 3.20, 95% CI 1.55-6.60) was observed in the CAZ-AVI group compared with the comparator group. Data provided here may be considered while using CAZ-AVI for the treatment of patients with difficult-to-treat infections. Systematic review registration: PROSPERO CRD42022362856. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_1ea00a9d24f0a9b696c5bc2a3d48f09b |
| institution | Universitat Pompeu Fabra |
| instname_str | Universitat Pompeu Fabra |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositori.upf.edu:10230/60757 |
| publishDate | 2024 |
| publishDateSort | 2024 |
| publisher | Springer |
| publisherStr | Springer |
| reponame_str | Repositorio Digital de la UPF |
| spelling | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis Shields, Ryan K. Horcajada Gallego, Juan Pablo Kamat, Shweta Irani, Paurus M. Tawadrous, Margaret Welte, Tobias Bacteremia Ceftazidime-avibactam Clinical cure Hospital-associated pneumonia Mortality Nosocomial pneumonia Ventilator-associated pneumonia Introduction: Ceftazidime-avibactam (CAZ-AVI) is a combination of the third-generation cephalosporin ceftazidime and the novel, non-β-lactam β-lactamase inhibitor avibactam that is approved for the treatment of pediatric (≥ 3 months) and adult patients with complicated infections including hospital-acquired and ventilator-associated pneumonia (HAP/VAP), and bacteremia. This systematic literature review and meta-analysis (PROSPERO registration: CRD42022362856) aimed to provide a quantitative and qualitative synthesis to evaluate the effectiveness of CAZ-AVI in treating adult patients with bacteremia or nosocomial pneumonia caused by carbapenem-resistant Enterobacterales (non metallo-β-lactamase-producing strains) and multi-drug resistant (MDR) Pseudomonas aeruginosa infections. Methods: The databases included in the search, until November 7, 2022, were Embase and PubMed. A total of 24 studies (retrospective: 22, prospective: 2) with separate outcomes for patients with bacteremia or pneumonia were included. Results: The outcomes assessed were all-cause mortality, clinical cure, and microbiological cure. Qualitative (24 studies) and quantitative (8/24 studies) syntheses were performed. The quality of the studies was assessed using the MINORS checklist and the overall risk of bias was moderate to high. Conclusions: In studies included in the meta-analysis, lower all-cause mortality for patients with bacteremia (OR = 0.30, 95% CI 0.19-0.46) and improved rates of clinical cure for patients with bacteremia (OR = 4.90, 95% CI 2.60-9.23) and nosocomial pneumonia (OR = 3.20, 95% CI 1.55-6.60) was observed in the CAZ-AVI group compared with the comparator group. Data provided here may be considered while using CAZ-AVI for the treatment of patients with difficult-to-treat infections. Systematic review registration: PROSPERO CRD42022362856. Springer http://hdl.handle.net/10230/60757 http://dx.doi.org/10.1007/s40121-024-00999-y |
| spellingShingle | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis Shields, Ryan K. Bacteremia Ceftazidime-avibactam Clinical cure Hospital-associated pneumonia Mortality Nosocomial pneumonia Ventilator-associated pneumonia |
| status_str | publishedVersion |
| title | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis |
| title_full | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis |
| title_fullStr | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis |
| title_full_unstemmed | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis |
| title_short | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis |
| title_sort | Ceftazidime-Avibactam in the treatment of patients with bacteremia or nosocomial pneumonia: A systematic review and meta-analysis |
| topic | Bacteremia Ceftazidime-avibactam Clinical cure Hospital-associated pneumonia Mortality Nosocomial pneumonia Ventilator-associated pneumonia |
| topic_facet | Bacteremia Ceftazidime-avibactam Clinical cure Hospital-associated pneumonia Mortality Nosocomial pneumonia Ventilator-associated pneumonia |
| url | http://hdl.handle.net/10230/60757 http://dx.doi.org/10.1007/s40121-024-00999-y |