Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 21, Issue 2, Pages 189-201Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14787210.2023.2166931
Keywords
Ceftolozane-tazobactam; Gram-negative bacteria; Pseudomonas aeruginosa; efficacy; safety; meta-analysis
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This study evaluated the clinical efficacy and safety of ceftolozane-tazobactam in treating Gram-negative bacterial infections. The results showed that ceftolozane-tazobactam had excellent clinical and microbiological efficacy in treating these infections. The safety profile of ceftolozane-tazobactam was comparable to other antimicrobials.
BackgroundCeftolozane-tazobactam is a novel cephalosporin/beta-lactamase inhibitor combination with activity against Gram-negative bacteria (GNB). We aimed to comprehensively evaluate the clinical efficacy and safety of ceftolozane-tazobactam in treating GNB infections in adult patients.Research design and methodsPubMed, Embase, and Cochrane databases were retrieved until August 2022. Randomized trials and non-randomized controlled studies evaluating ceftolozane-tazobactam and its comparators in adult patients with GNB infections were included.ResultsA total of 13 studies were included. Overall, patients receiving ceftolozane-tazobactam had significant advantages in clinical cure (odds ratio [OR], 1.62; 95% CI, 1.05-2.51) and microbiological eradication (OR, 1.43; 95% CI, 1.19-1.71), especially in Pseudomonas aeruginosa-infected patients. Ceftolozane-tazobactam had a significant advantage in clinical success or microbial eradication compared with polymyxin/aminoglycosides (PL/AG) or levofloxacin. There were no significant differences in adverse events (AEs), Clostridium difficile infection (CDI), and mortality between ceftolozane-tazobactam and comparators. Notably, ceftolozane-tazobactam showed a significantly lower risk of acute kidney injury compared with PL/AG.ConclusionsCeftolozane-tazobactam showed excellent clinical and microbiological efficacy in treating GNB, especially P. aeruginosa-induced infections. The overall safety profile of ceftolozane-tazobactam was comparable to other antimicrobials, with no increased risk of CDI and obvious advantage over antibacterial agents with high nephrotoxicity.
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