Lai Chih-Cheng, Cheng I-Ling, Chen Yu-Hung, Tang Hung-Jen
Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan.
Department of Pharmacy, Chi Mei Medical Center, Liouying 73657, Taiwan.
J Clin Med. 2019 Jul 2;8(7):958. doi: 10.3390/jcm8070958.
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, = 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, = 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, = 63%). Doripenem also had a similar microbiological eradication rate with comparators (OR, 1.08; 95% CI, 0.86-1.36, = 0%). Finally, doripenem had a similar risk of treatment-emergent adverse events as comparators (OR, 0.98; 95% CI, 0.83-1.17, = 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.
本研究旨在评估多利培南治疗急性细菌感染患者的疗效和安全性。检索了截至2019年4月的Pubmed、Embase和Cochrane数据库。仅纳入比较多利培南与其他对照药物治疗急性细菌感染的随机临床试验。主要结局为临床成功率，次要结局为微生物清除率和不良事件风险。纳入了八项随机对照试验（RCT）。总体而言，多利培南与对照药物的临床成功率相似（优势比[OR]为1.15；95%置信区间为0.79 - 1.66，I² = 58%）。多利培南与对照药物在治疗肺炎（OR为0.84；95%置信区间为0.46 - 1.53，I² = 72%）和腹腔内感染（OR为1.00；95%置信区间为0.57 - 1.72）方面的临床成功率相似。对于复杂性尿路感染，多利培南的成功率高于对照药物（OR为1.89，95%置信区间为1.13 - 3.17，I² = 0%）。比较多利培南与其他碳青霉烯类药物进行的汇总分析显示，二者之间无显著差异（OR为0.96，95%置信区间为0.59 - 1.58，I² = 63%）。多利培南与对照药物的微生物清除率也相似（OR为1.08；95%置信区间为0.86 - 1.36，I² = 0%）。最后，多利培南与对照药物出现治疗中不良事件的风险相似（OR为0.98；95%置信区间为0.83 - 1.17，I² = 33%）。总之，多利培南在治疗急性细菌感染方面的临床疗效与对照药物相当；此外，这种抗生素与对照药物的耐受性也相同。
