PDF(Pubmed)
Abstract：
BACKGROUND: 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.
BACKGROUND: PROSPERO CRD42022362856.
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.
BACKGROUND: PROSPERO CRD42022362856.
摘要：
背景：头孢他啶-阿维巴坦（CAZ-AVI）是第三代头孢菌素头孢他啶和新型头孢他啶的组合，非β-内酰胺β-内酰胺酶抑制剂阿维巴坦被批准用于治疗小儿（≥3个月）和成人患者的复杂感染，包括医院获得性和呼吸机相关性肺炎（HAP/VAP），和菌血症.这项系统的文献综述和荟萃分析（PROSPERO注册：CRD42022362856）旨在提供定量和定性综合，以评估CAZ-AVI治疗由耐碳青霉烯类肠杆菌（非金属-β-内酰胺酶产生菌株）和多药耐药（MDR）铜绿假单胞菌感染引起的菌血症或医院性肺炎的成年患者的有效性。
方法：搜索中包含的数据库，直到2022年11月7日，Embase和PubMed。共纳入24项研究（回顾性研究：22项，前瞻性研究：2项），分别为菌血症或肺炎患者。
结果：评估的结果是全因死亡率，临床治愈,和微生物治疗。进行了定性（24项研究）和定量（8/24项研究）综合。使用MINORS检查表评估研究质量，总体偏倚风险为中等至高。
结论：在荟萃分析中包含的研究中，与对照组相比,CAZ-AVI组的菌血症患者全因死亡率较低(OR=0.30,95%CI0.19~0.46),菌血症患者(OR=4.90,95%CI2.60~9.23)和医院获得性肺炎患者的临床治愈率提高(OR=3.20,95%CI1.55~6.60).在使用CAZ-AVI治疗难以治疗的感染患者时，可以考虑此处提供的数据。
背景：PROSPEROCRD42022362856.
方法：搜索中包含的数据库，直到2022年11月7日，Embase和PubMed。共纳入24项研究（回顾性研究：22项，前瞻性研究：2项），分别为菌血症或肺炎患者。
结果：评估的结果是全因死亡率，临床治愈,和微生物治疗。进行了定性（24项研究）和定量（8/24项研究）综合。使用MINORS检查表评估研究质量，总体偏倚风险为中等至高。
结论：在荟萃分析中包含的研究中，与对照组相比,CAZ-AVI组的菌血症患者全因死亡率较低(OR=0.30,95%CI0.19~0.46),菌血症患者(OR=4.90,95%CI2.60~9.23)和医院获得性肺炎患者的临床治愈率提高(OR=3.20,95%CI1.55~6.60).在使用CAZ-AVI治疗难以治疗的感染患者时，可以考虑此处提供的数据。
背景：PROSPEROCRD42022362856.
