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Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia
This study reports the integrated analysis of two phase III studies of novel β-lactam/β-lactamase combination versus meropenem for treating nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP). The ASPECT-NP trial compared the efficacy and safety of ceftolozane–tazobactam versus...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963743/ https://www.ncbi.nlm.nih.gov/pubmed/31766123 http://dx.doi.org/10.3390/antibiotics8040219 |
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author | Lin, Wei-Ting Lai, Chih-Cheng Cheong, Chong-Un |
author_facet | Lin, Wei-Ting Lai, Chih-Cheng Cheong, Chong-Un |
author_sort | Lin, Wei-Ting |
collection | PubMed |
description | This study reports the integrated analysis of two phase III studies of novel β-lactam/β-lactamase combination versus meropenem for treating nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP). The ASPECT-NP trial compared the efficacy and safety of ceftolozane–tazobactam versus meropenem for treating NP/VAP. The REPROVE trial compared ceftazidime–avibactam and meropenem in the treatment of NP/VAP. A total of 1528 patients (361 in the ceftolozane–tazobactam group; 405 in the ceftazidime–avibactam group; 762 in the meropenem group) were analyzed. The clinical cure rates at test-of-cure among the novel β-lactam/β-lactamase combinations group were non-inferior to those of the meropenem (70.7% vs. 72.1%, risk difference (RD) −0.01, 95% confidence interval (CI) 0.06–0.05) in the clinical evaluable populations. Overall 28-day mortality did not differ between novel β-lactam/β-lactamase combinations and the meropenem group (RD, −0.02, 95% CI, −0.09 to 0.05). Regarding the microbiological eradication rate, novel β-lactam/β-lactamase combinations were non-inferior to meropenem for Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae, Staphylococcus marcescens, and Enterobacter cloacae. Finally, novel β-lactam/β-lactamase combinations had a similar risk of (i) treatment-emergent adverse events (RD, 0.02, 95% CI, −0.02 to 0.06), (ii) events leading to the discontinuation of the study drug (RD, 0.00, 95% CI, −0.02 to 0.03), (iii) severe adverse events (RD, 0.03, 95% CI, −0.01 to 0.07), and (iv) death (RD, 0.02, 95% CI, −0.02 to 0.05) when compared with meropenem group. In conclusion, our findings suggest that novel β-lactam/β-lactamase combinations of ceftolozane−tazobactam and ceftazidime–avibactam can be recommended as one of the therapeutic options in the treatment of NP/VAP. |
format | Online Article Text |
id | pubmed-6963743 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-69637432020-01-27 Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia Lin, Wei-Ting Lai, Chih-Cheng Cheong, Chong-Un Antibiotics (Basel) Brief Report This study reports the integrated analysis of two phase III studies of novel β-lactam/β-lactamase combination versus meropenem for treating nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP). The ASPECT-NP trial compared the efficacy and safety of ceftolozane–tazobactam versus meropenem for treating NP/VAP. The REPROVE trial compared ceftazidime–avibactam and meropenem in the treatment of NP/VAP. A total of 1528 patients (361 in the ceftolozane–tazobactam group; 405 in the ceftazidime–avibactam group; 762 in the meropenem group) were analyzed. The clinical cure rates at test-of-cure among the novel β-lactam/β-lactamase combinations group were non-inferior to those of the meropenem (70.7% vs. 72.1%, risk difference (RD) −0.01, 95% confidence interval (CI) 0.06–0.05) in the clinical evaluable populations. Overall 28-day mortality did not differ between novel β-lactam/β-lactamase combinations and the meropenem group (RD, −0.02, 95% CI, −0.09 to 0.05). Regarding the microbiological eradication rate, novel β-lactam/β-lactamase combinations were non-inferior to meropenem for Pseudomonas aeruginosa, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae, Staphylococcus marcescens, and Enterobacter cloacae. Finally, novel β-lactam/β-lactamase combinations had a similar risk of (i) treatment-emergent adverse events (RD, 0.02, 95% CI, −0.02 to 0.06), (ii) events leading to the discontinuation of the study drug (RD, 0.00, 95% CI, −0.02 to 0.03), (iii) severe adverse events (RD, 0.03, 95% CI, −0.01 to 0.07), and (iv) death (RD, 0.02, 95% CI, −0.02 to 0.05) when compared with meropenem group. In conclusion, our findings suggest that novel β-lactam/β-lactamase combinations of ceftolozane−tazobactam and ceftazidime–avibactam can be recommended as one of the therapeutic options in the treatment of NP/VAP. MDPI 2019-11-13 /pmc/articles/PMC6963743/ /pubmed/31766123 http://dx.doi.org/10.3390/antibiotics8040219 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Brief Report Lin, Wei-Ting Lai, Chih-Cheng Cheong, Chong-Un Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia |
title | Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia |
title_full | Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia |
title_fullStr | Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia |
title_full_unstemmed | Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia |
title_short | Novel β-Lactam/β-Lactamase Combination Versus Meropenem for Treating Nosocomial Pneumonia |
title_sort | novel β-lactam/β-lactamase combination versus meropenem for treating nosocomial pneumonia |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963743/ https://www.ncbi.nlm.nih.gov/pubmed/31766123 http://dx.doi.org/10.3390/antibiotics8040219 |
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