title: Systematic Review and Meta-Analysis of the Efficacy and Safety of Telavancin for Treatment of Infectious Disease: Are We Clearer?
abstract: Objective:Telavancin is approved to treat complicated skin and skin structure infections, hospital-acquired, and ventilator-associated bacterial pneumonia caused byStaphylococcus aureus. A previous meta-analysis of randomized controlled trials suggested that it might be an alternative to vancomycin in cases of difficult-to-treat meticillin-resistantS. aureusinfections. We did a meta-analysis including one new trial to access the efficacy and safety of telavancin.Methods:We searched PubMed, Cochrane Central Register of Controlled Trials, EMBASE and ClinicalTrials.gov up to December 30, 2015 to identify randomized controlled trials that assessed the clinical efficacy, eradication efficiency, adverse events and laboratory abnormalities of telavancin vs. other antibiotic agents for bacterial infection. Meta-analysis was performed using Review Manager 5.3.0.Results:Five studies (3790 participants) were included in the meta-analysis. There was no significant difference in treatment success with telavancin than with control antibiotic agents. The pooled pathogen eradication for the telavancin group was numerically higher than that for the control groups, but there was no significant difference. While all-cause mortalities and serious adverse events were comparable between telavancin and control antibiotic agents, adverse event-related withdrawals (OR 1.47, 95% CI 1.13-1.91) were higher in telavancin group. The total number adverse events were more in the telavancin group than in the control groups, especially in the digestive system (OR 1.57, 95% CI 1.37-1.79), nervous system (OR 2.14, 95% CI 1.86-2.47) and urogenital system (OR 2.54, 95% CI 1.99-3.25). Serum creatinine increase (OR 2.25, 95% Cl 1.78-2.85) and hypokalemia (OR 1.74, 95% CI 1.19-2.53) occurred more frequently in telavancin group compared to control groups.Conclusion:Telavancin may be as effective as but no better than the comparison therapy forS. aureusinfection. However, because of the high risk of adverse event-related withdrawals and potential nephrotoxicity, prudence with the clinical use of telavancin in infections is required.
authors.affiliation: Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Chengdu, China.
authors.forename: Junlan
authors.initials: J
authors.lastname: Chuan
authors.affiliation: Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Chengdu, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Chengdu, China.
authors.forename: Xia
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Chengdu, China.
authors.forename: Yuxuan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Chengdu, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Chengdu, China.
authors.forename: Dongke
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China Chengdu, China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Xiao
keywords: efficacy; infectious disease; safety; systematic analysis; telavancin