Meta-analysis: ertapenem for complicated intra-abdominal infections.

Abstract

BACKGROUND:

Ertapenem is a new member of the carbapenem class of antibiotics, with a favourable pharmacokinetic profile, but a narrower spectrum of antimicrobial activity, compared with older representatives of this class.

AIM:

To evaluate the effectiveness and safety of ertapenem for treatment of complicated intra-abdominal infections.

METHODS:

We performed a meta-analysis of randomized-controlled trials identified in PubMed, Cochrane and Scopus that compared ertapenem with other antimicrobial regimens, in patients of all ages, with complicated intra-abdominal infections. The primary outcomes evaluated were clinical success (cure or improvement) in the modified intention-to-treat population and clinical adverse events.

RESULTS:

Six randomized-controlled trials involving patients with complicated intra-abdominal infections, mainly of mild-to-moderate severity (three with a double-blind design; one performed in children) that compared ertapenem treatment (once daily) against piperacillin/tazobactam, ceftriaxone plus metronidazole and ticarcillin/clavulanic acid (in three, two and one randomized-controlled trials respectively) were included. No difference was found between adult patients with complicated intra-abdominal infections treated with ertapenem vs. comparators, regarding clinical success (five randomized-controlled trials, 2002 patients, fixed-effect model, odds ratio: 1.11, 95% confidence interval (CI): 0.89-1.39); clinical adverse events (four randomized-controlled trials, 1530 patients, fixed-effect model, OR: 0.86, 95% CI: 0.61-1.20); microbiological success; mortality and withdrawals because of adverse events. Ertapenem was associated with more laboratory adverse events (four randomized-controlled trials, 1530 patients, fixed-effect model, OR: 1.73, 95% CI: 1.14-2.61), but none was reported as serious.

CONCLUSION:

This meta-analysis provides additional evidence that ertapenem can be used as effectively and safely, as other recommended antimicrobial regimens, for the treatment of complicated intra-abdominal infections, particularly of mild-to-moderate severity.

• Authors: M E Falagas, G Peppas, G C Makris, D E Karageorgopoulos, D K Matthaiou
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 27 Issue 10 Pg. 919-31 (May 2008) ISSN: 1365-2036 [Electronic] England
• PMID: 18266994 (Publication Type: Journal Article, Meta-Analysis)

Chemical References

• Anti-Bacterial Agents
• beta-Lactams
• Ertapenem

Topics

• Abdomen
• Anti-Bacterial Agents (therapeutic use)
• Bacterial Infections (drug therapy)
• Ertapenem
• Humans
• Randomized Controlled Trials as Topic
• Treatment Outcome
• beta-Lactams (therapeutic use)