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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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