The use of ceftolozane-tazobactam in the treatment of complicated intra-abdominal infections and urinary tract infections—A meta-analysis of randomized controlled trials

Abstract Objects This study aims to assess the clinical efficacy and safety of ceftolozane-tazobactam in the treatment of complicated intra-abdominal infection (cIAI) and complicated urinary tract infection (cUTI) in adult patients through meta-analysis. Methods PubMed, Embase, and Cochrane databases were searched up to June 2019. Only randomized controlled trials (RCTs) that evaluated ceftolozane-tazobactam and other comparators for treating cIAI and cUTI in adult patients were included. The primary outcome was the clinical cure rate, whereas the secondary outcomes were clinical failure rate, microbiological eradication rate, and risk of an adverse event (AE). Results Three RCTs were included. Overall, ceftolozane-tazobactam had a clinical cure rate similar to comparators in the microbiological intent-to-treat (mITT) population (odds ratio [OR], 0.87; 95% confidence interval [CI], 0.43–1.79; I2 = 73%) and in the clinically evaluable population (OR, 1.22; 95% CI, 0.79–1.88; I2 = 0%). Furthermore, ceftolozane-tazobactam had a similar rate microbiological eradication for pathogens (OR, 1.31; 95% CI, 0.42–4.10; I2 = 37%). Finally, the risks of treatment-emergent AEs (OR, 1.04; 95% CI, 0.87–1.23; I2 = 0%), serious AEs (OR, 1.16; 95% CI, 0.67–1.99; I2 = 37%), discontinuation of study drug due to an AE (OR, 0.77; 95% CI, 0.17–3.47) and mortality (OR, 1.62; 95% CI, 0.69–3.77, I2 = 0%) between ceftolozane-tazobactam and comparators did not differ significantly. Conclusions The clinical efficacy of ceftolozane-tazobactam is as high as that of comparators in the treatment of cIAI and cUTI in adult patients, and this antibiotic is well tolerated like comparators.