Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
This systematic review and meta-analysis of randomized controlled trials (RCTs) compared the clinical efficacy and safety of anti-MRSA cephalosporin and vancomycin-based treatment in treating acute bacterial skin and skin structure infections (ABSSSIs). PubMed, Embase, Cochrane Central Register of C...
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| Format: | Article |
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MDPI AG
2021-08-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/10/8/1020 |
| _version_ | 1797524878834794496 |
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| author | Ching-Yi Chen Wang-Chun Chen Chih-Cheng Lai Tzu-Ping Shih Hung-Jen Tang |
| author_facet | Ching-Yi Chen Wang-Chun Chen Chih-Cheng Lai Tzu-Ping Shih Hung-Jen Tang |
| author_sort | Ching-Yi Chen |
| collection | DOAJ |
| description | This systematic review and meta-analysis of randomized controlled trials (RCTs) compared the clinical efficacy and safety of anti-MRSA cephalosporin and vancomycin-based treatment in treating acute bacterial skin and skin structure infections (ABSSSIs). PubMed, Embase, Cochrane Central Register of Controlled Trials, Turning Research into Practice, and ClinicalTrials.gov databases were searched for relevant articles from inception to 15 June 2020. RCTs comparing the clinical efficacy and safety of anti-MRSA cephalosporin with those of vancomycin-based regimens in treating adult patients with ABSSSIs were included. The primary and secondary outcomes were clinical response at the test-of-cure assessments and risk of adverse events (AEs), respectively. Eight RCTs were enrolled. The clinical response rate was not significantly different between anti-MRSA cephalosporin and vancomycin-based treatments (odds ratio [OR], 1.05; 95% CI, 0.90–1.23; <i>I</i><sup>2</sup> = 0%). Except for major cutaneous abscesses in which anti-MRSA cephalosporin-based treatment was associated with a lower clinical response rate than vancomycin-based treatment (OR, 0.62; 95% CI, 0.40–0.97; <i>I</i><sup>2</sup> = 0%), other subgroup analyses according to the type of cephalosporin (ceftaroline or ceftobiprole), type of infection, and different pathogens did not show significant differences in clinical response. Anti-MRSA cephalosporin-based treatment was only associated with a higher risk of nausea than vancomycin-based treatment (OR, 1.41; 95% CI, 1.07–1.85; <i>I</i><sup>2</sup> = 0%). In treating ABSSSIs, the clinical efficacy of anti-MRSA cephalosporin is comparable to that of vancomycin-based treatment, except in major cutaneous abscesses. In addition to nausea, anti-MRSA cephalosporin was as tolerable as vancomycin-based treatment. |
| first_indexed | 2024-03-10T09:03:51Z |
| format | Article |
| id | doaj.art-f23e3d70912843b6b6a9ab1558ddf669 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T09:03:51Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-f23e3d70912843b6b6a9ab1558ddf6692023-11-22T06:34:47ZengMDPI AGAntibiotics2079-63822021-08-01108102010.3390/antibiotics10081020Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsChing-Yi Chen0Wang-Chun Chen1Chih-Cheng Lai2Tzu-Ping Shih3Hung-Jen Tang4Division of Chest Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 82445, TaiwanInstitute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 82445, TaiwanDepartment of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 71051, TaiwanDepartment of Family Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 71051, TaiwanDepartment of Medicine, Chi Mei Medical Center, Tainan 71004, TaiwanThis systematic review and meta-analysis of randomized controlled trials (RCTs) compared the clinical efficacy and safety of anti-MRSA cephalosporin and vancomycin-based treatment in treating acute bacterial skin and skin structure infections (ABSSSIs). PubMed, Embase, Cochrane Central Register of Controlled Trials, Turning Research into Practice, and ClinicalTrials.gov databases were searched for relevant articles from inception to 15 June 2020. RCTs comparing the clinical efficacy and safety of anti-MRSA cephalosporin with those of vancomycin-based regimens in treating adult patients with ABSSSIs were included. The primary and secondary outcomes were clinical response at the test-of-cure assessments and risk of adverse events (AEs), respectively. Eight RCTs were enrolled. The clinical response rate was not significantly different between anti-MRSA cephalosporin and vancomycin-based treatments (odds ratio [OR], 1.05; 95% CI, 0.90–1.23; <i>I</i><sup>2</sup> = 0%). Except for major cutaneous abscesses in which anti-MRSA cephalosporin-based treatment was associated with a lower clinical response rate than vancomycin-based treatment (OR, 0.62; 95% CI, 0.40–0.97; <i>I</i><sup>2</sup> = 0%), other subgroup analyses according to the type of cephalosporin (ceftaroline or ceftobiprole), type of infection, and different pathogens did not show significant differences in clinical response. Anti-MRSA cephalosporin-based treatment was only associated with a higher risk of nausea than vancomycin-based treatment (OR, 1.41; 95% CI, 1.07–1.85; <i>I</i><sup>2</sup> = 0%). In treating ABSSSIs, the clinical efficacy of anti-MRSA cephalosporin is comparable to that of vancomycin-based treatment, except in major cutaneous abscesses. In addition to nausea, anti-MRSA cephalosporin was as tolerable as vancomycin-based treatment.https://www.mdpi.com/2079-6382/10/8/1020acute bacterial skin and skin structure infectionceftarolineceftobiprolevancomycinmethicillin-resistant <i>Staphylococcus aureus</i> |
| spellingShingle | Ching-Yi Chen Wang-Chun Chen Chih-Cheng Lai Tzu-Ping Shih Hung-Jen Tang Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Antibiotics acute bacterial skin and skin structure infection ceftaroline ceftobiprole vancomycin methicillin-resistant <i>Staphylococcus aureus</i> |
| title | Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | Anti-MRSA Cephalosporin versus Vancomycin-Based Treatment for Acute Bacterial Skin and Skin Structure Infection: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | anti mrsa cephalosporin versus vancomycin based treatment for acute bacterial skin and skin structure infection a systematic review and meta analysis of randomized controlled trials |
| topic | acute bacterial skin and skin structure infection ceftaroline ceftobiprole vancomycin methicillin-resistant <i>Staphylococcus aureus</i> |
| url | https://www.mdpi.com/2079-6382/10/8/1020 |
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