Global evaluation of the antibacterial activity of Ceftolozane/Tazobactam against ESBLs-producing and : a systematic review and meta-analysis.

BACKGROUND

Ceftolozane/Tazobactam is a β-lactam/β-lactamase inhibitor combination with a high range of efficacy and broad-spectrum action against multidrug-resistant bacterial strains.

OBJECTIVES

The present study aimed to analyze the activity of Ceftolozane/Tazobactam against extended-spectrum β-lactamases (ESBLs)-producing (ESBLs-EC) and (ESBLs-KP) in the published literature to provide international data on the antimicrobial stewardship programs.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic literature search was conducted on the Web of Science, Embase, PubMed, Scopus, and Google Scholar electronic databases from the beginning of databases to December 2022 to cover all published articles relevant to our scope.

RESULTS

At last, 31 publications that met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of Ceftolozane/Tazobactam susceptibility for ESBLs-EC and ESBLs-KP was estimated at 91.3% [95% confidence interval (CI): 90.1-92.5%] and 65.6% (95% CI: 60.8-70.2%), respectively. There was significant heterogeneity among the 31 studies for ESBLs-EC (χ = 91.621;  < 0.001;  = 67.256%) and ESBLs-KP (χ = 348.72;  < 0.001;  = 91.4%). Most clinical isolates of ESBLs-EC had MIC and MIC at a concentration of 0.5 and 2 µg/mL [minimum inhibitory concentration (MIC) at which 50% and 90% of isolates were inhibited], respectively. In contrast, most clinical isolates of ESBLs-KP had MIC and MIC at a concentration of 1 and 32 µg/mL, respectively.

CONCLUSION

Based on the meta-analysis results, Ceftolozane/Tazobactam has a more promising antibacterial activity against ESBLs-EC isolates from different clinical sources than ESBLs-KP isolates. Therefore, Ceftolozane/Tazobactam can be a useful therapeutic drug as an alternative to carbapenems. Randomized clinical trials are needed to provide clinical evidence to support these observations.