Abstract
This study aims to assess the efficacy and safety of doripenem on treating patients with acute bacterial infections. The Pubmed, Embase, and Cochrane databases were searched up to April 2019. Only randomized clinical trials comparing doripenem and other comparators for the treatment of acute bacterial infection were included. The primary outcome was the clinical success rate and the secondary outcomes were microbiological eradication rate and risk of adverse events. Eight randomized controlled trials (RCTs) were included. Overall, doripenem had a similar clinical success rate with comparators (odds ratio [OR], 1.15; 95% CI, 0.79–1.66, I2 = 58%). Similar clinical success rates were noted between doripenem and comparators for pneumonia (OR, 0.84; 95% CI, 0.46–1.53, I2 = 72%) and for intra-abdominal infections (OR, 1.00; 95% CI, 0.57–1.72). For complicated urinary tract infection, doripenem was associated with higher success rate than comparators (OR, 1.89, 95% CI, 1.13–3.17, I2 = 0%). The pool analysis comparing doripenem and other carbapenems showed no significant differences between each other (OR, 0.96, 95% CI, 0.59–1.58, I2 = 63%). Doripenem also had a similar microbiological eradication rate with comparators (OR, 1.08; 95% CI, 0.86–1.36, I2 = 0%). Finally, doripenem had a similar risk of treatment-emergent adverse events as comparators (OR, 0.98; 95% CI, 0.83–1.17, I2 = 33%). In conclusion, the clinical efficacy of doripenem is as high as that of the comparator drugs in the treatment of acute bacterial infection; furthermore, this antibiotic is as well tolerated as the comparators.
Highlights
Carbapenems, including imipenem and meropenem, remain the mainstay of treatment for hospital-acquired infections, especially for the multidrug-resistant organism associated infections [1]
Doripenem is approved for the treatment of patients with complicated intra-abdominal infection, complicated urinary tract infection and pyelonephritis, and healthcare-associated pneumonia (HAP) including ventilator-associated pneumonia (VAP) in Europe and in other countries, other than United States
Studies were considered eligible for inclusion if they directly compared the clinical effectiveness of doripenem with other antimicrobial agents in the treatment of adult patients with acute bacterial infections
Summary
Carbapenems, including imipenem and meropenem, remain the mainstay of treatment for hospital-acquired infections, especially for the multidrug-resistant organism associated infections [1] Doripenem is another important carbapenem, and has excellent bactericidal activity against most nosocomial pathogens according to several in vitro studies [2,3,4,5]. A global surveillance showed that doripenem was at least two-fold more potent in in vitro activities than imipenem and meropenem against Pseudomonas aeruginosa—an important nosocomial pathogen [3]. We could conduct a comprehensive review and updated meta-analysis to assess the efficacy and safety of doripenem on treating patients with acute bacterial infections in comparison with other antibiotics, especially imipenem and meropenem
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