Ceftaroline fosamil for community-acquired pneumonia and skin and skin structure infections: a systematic review

被引:15
作者
El Hajj, Maguy Saffouh [1 ]
Turgeon, Ricky D. [2 ]
Wilby, Kyle John [1 ]
机构
[1] Qatar Univ, Coll Pharm, POB 2713, Doha, Qatar
[2] Vancouver Gen Hosp, Vancouver, BC, Canada
关键词
Antibiotics; Ceftaroline fosamil; Cephalosporins; Community-acquired pneumonia; Skin infections; GUIDELINES; MANAGEMENT;
D O I
10.1007/s11096-016-0417-z
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background Ceftaroline is a parentally administered cephalosporin that has an in vitro expanded spectrum of activity compared with other cephalosporins yet data is conflicting regarding its place in therapy. Aim of the Review To compare the efficacy and safety of ceftaroline against standard antibiotic regimens for community-acquired pneumonia (CAP) and complicated skin and skin structure infections (cSSSIs). Method The databases of MEDLINE, EBSCO, and Embase were searched up to June 2016. Manual review of references was completed and experts in the field were contacted for unpublished data. Randomized controlled trials of ceftaroline in CAP or cSSSI populations were included. Outcomes included clinical cure, mortality, adverse events, serious adverse events, and discontinuation due to adverse events. Meta-analysis was used to pool results for these outcomes. We performed subgroup analyses for gram positive infections in CAP and infections caused by methicillin-resistant Staphylococcus aureus in cSSSIs. Risk of bias was assessed for all studies. Results Six trials (three for each indication) were included, each of which had an unclear or high risk of bias in at least one domain. For CAP, ceftaroline was significantly more efficacious in achieving clinical cure than ceftriaxone [risk ratio (RR) 1.11, 95% confidence interval (CI) 1.04-1.19; I-2 = 47%]. For cSSSIs, there was no significant difference in clinical cure between ceftaroline and vancomycin plus aztreonam (RR 1.01, 95% CI 0.97-1.05; I-2 = 0%). No differences were found for overall mortality, serious adverse events, discontinuation due to adverse events, and overall adverse events. Conclusion Ceftaroline is a viable therapeutic alternative for patients with CAP and cSSSIs, yet identified risks of bias and poor external validity preclude it from being recommended as a first-line agent.
引用
收藏
页码:26 / 32
页数:7
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