Ertapenem versus piperacillin/tazobactam for the treatment of complicated infections: a meta-analysis of randomized controlled trials.
BACKGROUND
Ertapenem, a new carbapenem with a favorable pharmacokinetic profile, has been approved for the treatment of complicated intra-abdominal Infections (cIAIs), acute pelvic infections (APIs) and complicated skin and skin-structure infections (cSSSIs). The aim of this study is to compare the efficacy and safety of ertapenem with piperacillin/tazobactam, which has been reported to possess good efficacy for the treatment of these complicated infections.


METHODS
We performed a meta-analysis of randomized controlled trials identified in PubMed, Cochrane library and Embase that compared the efficacy and safety of ertapenem with piperacillin/tazobactam for the treatment of complicated infections including cIAIs, APIs, cSSSIs. The primary efficacy outcome was clinical treatment success assessed at the test-of-cure visit. The primary safety outcome was drug related clinical and laboratory adverse events occurred during the treatment and the post-treatment period.


RESULTS
Six RCTs, involving 3161 patients, were included in our meta-analysis. Ertapenem was associated similar clinical treatment success with piperacillin/tazobactam for complicated infections treatment (clinically evaluable population, 1937 patients, odds ratios: 1.15, 95% confidence intervals: 0.89-1.49; modified intention to treat population, 2855 patients, odds ratios: 1.03, 95% confidence intervals: 0.87-1.22). All of secondary efficacy outcomes analysis obtained similar findings with clinical treatment success. No difference was found about the incidence of drug related adverse events between ertapenem and piperacillin/tazobactam groups.


CONCLUSIONS
This meta-analysis provides evidence that ertapenem 1 g once a day can be used as effectively and safely as recommended dose of piperacillin/tazobactam, for the treatment of complicated infections, particularly of mild to moderate severity. It is an appealing option for the treatment of these complicated infections.
An
Mao Mao
MM
Department of Clinical Pharmacology, Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, PR China. maoan168@yahoo.com.cn
Zou
Zui
Z
Shen
Hui
H
Zhang
Jun Dong
JD
Chen
Meng Li
ML
Liu
Ping
P
Wang
Rui
R
Jiang
Yuan Ying
YY
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D000077727:Ertapenem; D006801:Humans; D010397:Penicillanic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010878:Piperacillin / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D000078142:Tazobactam; D016896:Treatment Outcome; D047090:beta-Lactams / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D010397:Penicillanic Acid; D000077727:Ertapenem; D000078142:Tazobactam; D010878:Piperacillin