Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trials
Objectives: This study assessed the efficacy and safety of novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations in adult patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). Methods: PubMed, Web of Science, the Cochrane Library, Ovid MEDLINE, Embase and EBS...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716521002381 |
| _version_ | 1818230790885998592 |
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| author | Huamei Zhuang Chih-Cheng Lai Shao-Huan Lan Shen-Peng Chang Li-Chin Lu Shun-Hsing Hung Wei-Ting Lin |
| author_facet | Huamei Zhuang Chih-Cheng Lai Shao-Huan Lan Shen-Peng Chang Li-Chin Lu Shun-Hsing Hung Wei-Ting Lin |
| author_sort | Huamei Zhuang |
| collection | DOAJ |
| description | Objectives: This study assessed the efficacy and safety of novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations in adult patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). Methods: PubMed, Web of Science, the Cochrane Library, Ovid MEDLINE, Embase and EBSCO databases were searched for randomised controlled trials (RCTs) published before 13 September 2020. Only RCTs comparing the treatment efficacy of novel BL/BLI combinations with other antibiotics for HAP/VAP in adult patients were included in this integrated analysis. Results: Three RCTs were included and no significant difference in clinical cure rate of test of cure was observed between the novel BL/BLI combinations and comparators [odds ratio (OR) = 1.01, 95% confidence interval (CI) 0.81–1.27; I2 = 35%]. The 28-day all-cause mortality was 16.2% and 17.6% for patients receiving novel BL/BLI combinations and comparators, respectively, and no significant difference was noted (OR = 0.90, 95% CI 0.69–1.16; I2 = 11%). Compared with comparators, novel BL/BLI combinations were associated with a similar microbiological response (OR = 1.06, 95% CI 0.73–1.54; I2 = 64%) and a similar risk of adverse events (AEs) [treatment-emergent AEs (TEAEs): OR = 1.04, 95% CI 0.83–1.30; I2 = 0%; serious AEs: OR = 1.14, 95% CI 0.79–1.63; I2 = 68%; treatment discontinuation for TEAE: OR = 0.90, 95% CI 0.62–1.31; I2 = 11%). Conclusion: Clinical and microbiological responses of novel BL/BLI combinations in the treatment of HAP/VAP were similar to those of other available antibiotics. These combinations also shared a similar safety profile to comparators. |
| first_indexed | 2024-12-12T10:40:06Z |
| format | Article |
| id | doaj.art-0c37f84151d74ad7802f6236fe329891 |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-12-12T10:40:06Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-0c37f84151d74ad7802f6236fe3298912022-12-22T00:27:04ZengElsevierJournal of Global Antimicrobial Resistance2213-71652022-06-0129398404Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trialsHuamei Zhuang0Chih-Cheng Lai1Shao-Huan Lan2Shen-Peng Chang3Li-Chin Lu4Shun-Hsing Hung5Wei-Ting Lin6School of Pharmaceutical Sciences and Medical Technology, Putian University, Putian 351100, ChinaDepartment of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, TaiwanSchool of Pharmaceutical Sciences and Medical Technology, Putian University, Putian 351100, ChinaYijia Pharmacy, Tainan 70846, TaiwanSchool of Management, Putian University, Putian 351100, ChinaDivision of Urology, Department of Surgery, Chi-Mei Hospital, Chia Li, Tainan, Taiwan; Corresponding authors.Department of Orthopedics, Chi Mei Medical Center, Tainan 71004, Taiwan; Corresponding authors.Objectives: This study assessed the efficacy and safety of novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations in adult patients with hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP). Methods: PubMed, Web of Science, the Cochrane Library, Ovid MEDLINE, Embase and EBSCO databases were searched for randomised controlled trials (RCTs) published before 13 September 2020. Only RCTs comparing the treatment efficacy of novel BL/BLI combinations with other antibiotics for HAP/VAP in adult patients were included in this integrated analysis. Results: Three RCTs were included and no significant difference in clinical cure rate of test of cure was observed between the novel BL/BLI combinations and comparators [odds ratio (OR) = 1.01, 95% confidence interval (CI) 0.81–1.27; I2 = 35%]. The 28-day all-cause mortality was 16.2% and 17.6% for patients receiving novel BL/BLI combinations and comparators, respectively, and no significant difference was noted (OR = 0.90, 95% CI 0.69–1.16; I2 = 11%). Compared with comparators, novel BL/BLI combinations were associated with a similar microbiological response (OR = 1.06, 95% CI 0.73–1.54; I2 = 64%) and a similar risk of adverse events (AEs) [treatment-emergent AEs (TEAEs): OR = 1.04, 95% CI 0.83–1.30; I2 = 0%; serious AEs: OR = 1.14, 95% CI 0.79–1.63; I2 = 68%; treatment discontinuation for TEAE: OR = 0.90, 95% CI 0.62–1.31; I2 = 11%). Conclusion: Clinical and microbiological responses of novel BL/BLI combinations in the treatment of HAP/VAP were similar to those of other available antibiotics. These combinations also shared a similar safety profile to comparators.http://www.sciencedirect.com/science/article/pii/S2213716521002381Novel β-lactam/β-lactamase inhibitorHospital-acquired pneumoniaVentilator-associated pneumoniaMortality |
| spellingShingle | Huamei Zhuang Chih-Cheng Lai Shao-Huan Lan Shen-Peng Chang Li-Chin Lu Shun-Hsing Hung Wei-Ting Lin Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trials Journal of Global Antimicrobial Resistance Novel β-lactam/β-lactamase inhibitor Hospital-acquired pneumonia Ventilator-associated pneumonia Mortality |
| title | Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trials |
| title_full | Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trials |
| title_fullStr | Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trials |
| title_full_unstemmed | Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trials |
| title_short | Novel β-lactam/β-lactamase inhibitor combinations versus alternative antibiotics in adults with hospital-acquired pneumonia or ventilator-associated pneumonia: an integrated analysis of three randomised controlled trials |
| title_sort | novel β lactam β lactamase inhibitor combinations versus alternative antibiotics in adults with hospital acquired pneumonia or ventilator associated pneumonia an integrated analysis of three randomised controlled trials |
| topic | Novel β-lactam/β-lactamase inhibitor Hospital-acquired pneumonia Ventilator-associated pneumonia Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2213716521002381 |
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