Abstract
This meta-analysis assessed the efficacy and safety of novel tetracyclines for treating acute bacterial infections. Data from PubMed, Web of Science, EBSCO, Cochrane databases, Ovid Medline, and Embase databases were accessed until 11 July 2019. Only randomized controlled trials (RCTs) comparing the efficacy of novel tetracyclines with that of other antibiotics for treating acute bacterial infections were included. Primary outcomes included the clinical response, microbiological response, and risk of adverse events (AEs). A total of eight RCTs were included, involving 2283 and 2197 patients who received novel tetracyclines and comparators, respectively. Overall, no significant difference was observed in the clinical response rate at test of cure between the experimental and control groups (for modified intent-to-treat [MITT] population, risk ratio [RR]: 1.02, 95% confidence interval [CI]: 0.99–1.05; for clinically evaluable [CE] population, RR: 1.02, 95% CI: 1.00–1.04; and for microbiological evaluable [ME] population, RR: 1.01, 95% CI: 0.99–1.04). No significant difference in the microbiological response at the end of treatment was observed between the experimental and control groups (for ME population, RR: 1.01, 95% CI: 0.99–1.03; for microbiological MITT population, RR: 1.01, 95% CI: 0.96–1.07). No difference was observed concerning the risk of treatment-emergent adverse events (TEAEs), serious adverse events, and discontinuation of treatment due to TEAEs and all-cause mortality between the two groups. In conclusion, clinical efficacy and safety profile for novel tetracyclines in the treatment of acute bacterial infections were found to be similar to those for other available antibiotics.
Highlights
Antibiotics are crucial for treating acute bacterial infections, and the prompt use of appropriate antibiotics can save the life of a patient with sepsis [1]
No consensus on the efficacy and safety of novel tetracyclines has been reached due to the lack of a systematic analysis and an updated meta-analysis. We conducted this meta-analysis to provide a real-time evidence on the efficacy and safety of omadacycline and eravacycline for treating acute bacterial infections
4480 patients were compare theinfections, efficacy and safety complicated intrainfections (cIAIs), of novel novel tetracyclines and other regimens forcollated treatingto acute bacterial including tetracyclines and other antibiotic regimens for treating acute bacterial infections, including cIAIs, ABSSSIs, ABSSSIs, community-acquired bacterial pneumonia (CABP), and complicated urinary tract infection (cUTI). We demonstrated that these novel tetracyclines could the present study, we comparators, demonstratedwhich that these novel tetracyclines could achieve a achieve similarIn clinical response as other is supported by the following evidence
Summary
Antibiotics are crucial for treating acute bacterial infections, and the prompt use of appropriate antibiotics can save the life of a patient with sepsis [1]. Two novel tetracyclines, omadacycline, (Nuzyra® , Paratek Pharmaceuticals, Boston, MA, USA) and eravacycline (Xerava® , Tetraphase Pharmaceuticals, Watertown, MA, USA), have been developed and approved by the Food and Drug Administration in 2018 [8]. They are broad-spectrum antibiotics such as conventional tetracyclines that act against gram-positive, gram-negative, anaerobic, and atypical pathogens. No consensus on the efficacy and safety of novel tetracyclines has been reached due to the lack of a systematic analysis and an updated meta-analysis We conducted this meta-analysis to provide a real-time evidence on the efficacy and safety of omadacycline and eravacycline for treating acute bacterial infections
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