Abstract
This study aimed to compare the clinical efficacy and safety of ceftaroline with those of ceftriaxone for treating community-acquired pneumonia (CAP). The PubMed, Cochrane Library, Embase, and clinicalTrials.gov databases were searched until April 2019. This meta-analysis only included randomized controlled trials (RCTs) that evaluated ceftaroline and ceftriaxone for the treatment of CAP. The primary outcome was the clinical cure rate, and the secondary outcome was the risk of adverse events (AEs). Five RCTs were included. Overall, at the test of cure (TOC), the clinical cure rate of ceftaroline was superior to the rates of ceftriaxone for the treatment of CAP (modified intent-to-treat population (MITT) population, odds ratio (OR) 1.61, 95% confidence interval (CI) 1.31–1.99, I2 = 0%; clinically evaluable (CE) population, OR 1.38, 95% CI 1.07–1.78, I2 = 14%). Similarly, the clinical cure rate of ceftaroline was superior to that of ceftriaxone at the end of therapy (EOT) (MITT population, OR 1.57, 95% CI 1.16–2.11, I2 = 0%; CE population, OR 1.64, 95% CI 1.15–2.33, I2 = 0%). For adult patients, the clinical cure rate of ceftaroline remained superior to that of ceftriaxone at TOC (MITT population, OR 1.66, 95% CI 1.34–2.06, I2 = 0%; CE population, OR 1.39, 95% CI 1.08–1.80, I2 = 30%) and at EOT (MITT population, OR 1.64, 95% CI 1.20–2.24, I2 = 0%; CE population, OR 1.65, 95% CI 1.15–2.36, I2 = 0%). Ceftaroline and ceftriaxone did not differ significantly in the risk of serious AEs, treatment-emergent AEs, and discontinuation of the study drug owing to an AE. In conclusion, the clinical efficacy of ceftaroline is similar to that of ceftriaxone for the treatment of CAP. Furthermore, this antibiotic is as tolerable as ceftriaxone.
Highlights
Community-acquired pneumonia (CAP) is a common acute bacterial infection among adults and children and has become a significant global health problem [1,2,3,4]
All clinical studies were identified through a systematic review of the literature in the PubMed, Embase, ClinicalTrials.gov, and Cochrane databases until April 2019 using the following search terms: “ceftaroline”, “Teflaro”, “Zinforo”, “pneumonia”, and “randomized controlled trials (RCTs)”
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Summary
Community-acquired pneumonia (CAP) is a common acute bacterial infection among adults and children and has become a significant global health problem [1,2,3,4]. Severe CAP is associated with high morbidity and mortality, when prompt and appropriate treatment is not provided [5,6]. In addition to the most common CAP pathogen—Streptococcus pneumoniae, less than 8% of CAP can be caused by the so-called PES pathogens—Pseudomonas aeruginosa, extended-spectrum β-lactamase producing Enterobacteriaceae, and methicillin-resistant Staphylococcus aureus (MRSA), especially in intensive care unit (ICU) [8,9]. Among PES, MRSA is the most frequently reported, and it requires the use of specific antimicrobial agents for the treatment of typical CAP [10]. The antibiotics recommended for treating CAP when MRSA infection is suspected are vancomycin, teicoplanin, and linezolid [11,12,13]
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