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Review
. 2022 Aug 8:2022:1639114.
doi: 10.1155/2022/1639114. eCollection 2022.

A Meta-Analysis on Clinical Outcomes of Ceftolozane versus Piperacillin in Combination with Tazobactam in Patients with Complicated Urinary Tract Infections

Muhammad Waqas Saeed  1   2 , Syed Wasif Gillani  1 , Rana Kamran Mahmood  1   3 , Prasanna Vippadapu  1 , Mian Waqar Hussain  1   2 , Hassaan Anwer Rathore  4
Affiliations
Review

A Meta-Analysis on Clinical Outcomes of Ceftolozane versus Piperacillin in Combination with Tazobactam in Patients with Complicated Urinary Tract Infections

Muhammad Waqas Saeed et al. Biomed Res Int. .

Abstract

Objective: To evaluate efficacy and adverse events of ceftolozane/tazobactam in complicated UTI including acute pyelonephritis.

Method: Databases that include PubMed, Embase, Scopus, and TRIP were searched. All randomized controlled trials and cohort studies were considered for the study. Statistical analysis was done using a fixed effects model, and results were expressed in proportion for dichotomous data and risk ratio for continuous data with 95% confidence intervals (CI).

Results: A clinical cure of ceftolozane/tazobactam was found to be 92% with 95% CI of 90-94 while that of piperacillin/tazobactam was only 78% (95% CI, 74-82) in patients with complicated UTI. Microbiological eradication was still higher in the ceftolozane/tazobactam group (83%, 95% CI 81-88) when compared with piperacillin/tazobactam (63% 95% CI, 58.77-65.2). Ceftolozane/tazobactam was more effective in the treatment of complicated urinary tract infections other than acute pyelonephritis as compared to piperacillin/tazobactam (RR = 1.21, 95% CI, 1.07-1.23). Serious adverse events were found comparable in both groups (RR = 1.15, 95% CI, 0.64-2.09).

Conclusion: The analysis showed that ceftolozane/tazobactam has better clinical outcomes including cure rates and low resistance for the treatment of complicated urinary tract infection.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart.
Figure 2
Figure 2
Quality assessment of screened randomized controlled trials.
Figure 3
Figure 3
Forest plot of clinical cure of ceftolozane/tazobactam and piperacillin/tazobactam in patients with cUTI. Black squares indicate proportion, and horizontal lines indicate 95% CI.
Figure 4
Figure 4
Forest plot of microbiological eradication of ceftolozane/tazobactam and piperacillin/tazobactam in patients with cUTI. Black squares indicate proportion, and horizontal lines indicate 95% CI.
Figure 5
Figure 5
Forest plot for overall clinical success after 28 days of ceftolozane/tazobactam and piperacillin/tazobactam in patients with cUTI. Black squares indicate proportion, and horizontal lines indicate 95% CI.
See this image and copyright information in PMC

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References

    1. Pallett A., Hand K. Complicated urinary tract infections: practical solutions for the treatment of multiresistant gram-negative bacteria. Journal of Antimicrobial Chemotherapy . 2010;65(3):25–33. doi: 10.1093/jac/dkq298. - DOI - PubMed
    1. Nicolle L. E., Bradley S., Colgan R., et al. Infectious diseases society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clinical Infectious Diseases . 2005;40(5):643–654. doi: 10.1086/427507. - DOI - PubMed
    1. Nicolle L. E., Evans G., Laverdieve M., Phillips P., Quan C., Rotstein C. Complicated urinary tract infection in adults. Canadian Journal of Infectious Diseases and Medical Microbiology. Hindawi Limited . 2005;16(6):349–360. doi: 10.1155/2005/385768. - DOI - PMC - PubMed
    1. Neal D. E. Complicated urinary tract infections. Urologic Clinics of North America . 2008;35(1):13–22. doi: 10.1016/j.ucl.2007.09.010. - DOI - PubMed
    1. Shigemura K., Arakawa S., Tanaka K., Fujisawa M. Clinical investigation of isolated bacteria from urinary tracts of hospitalized patients and their susceptibilities to antibiotics. Journal of Infection and Chemotherapy . 2020;15(1):18–22. https://pubmed.ncbi.nlm.nih.gov/19280295/ - PubMed

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