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Background As a global health challenge, multidrug-resistant Enterobacteriaceae (MDR-EB) infection in inpatients shows an upward trend in its incidence and degree of severity. Objective To systematically evaluate the efficacy and safety of ceftazidime/avibactam (CAZ/AVI) in MDR-EB infection. Methods Databases including China National Knowledge Infrastructure, Wanfang Data, CQVIP, PubMed, EMBase, and Cochrane Library were searched for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) about treating MDR-EB infection using CAZ/AVI (experimental group) versus other treatments (control group) from inception to February 2021. Literature selection, data extraction and quality evaluation were carried out by two reviewers. Meta-analysis was performed using the RevMan 5.1. Results In all, 12 articles involving 15 trials were included. Meta-analysis indicated that both groups had no significant differences in clinical cure rate〔OR=1.02, 95%CI (0.73, 1.43), P=0.90〕, MDR-EB clearance rate〔OR=1.23, 95%CI (0.96, 1.58), P=0.10〕 and rate of adverse drug reactions〔OR=1.02, 95%CI (0.85, 1.22), P=0.84〕. But the mortality rate〔OR=0.72, 95%CI (0.52, 0.99), P=0.04〕 was lower for experimental group. The funnel plot was basically symmetrical in shape in assessing the existence of publication bias in the articles in terms of the clinical cure rate. Egger's test identified no publication bias in the articles regarding clinical cure rate, MDR-EB clearance rate and mortality rate (P=0.234, 0.679, 0.056) . Conclusion CAZ/AVI treatment could reduce the mortality rate in patients infected with MDR-EB, which may be used as an alternative for MDR-EB infection, especially carbapenem-resistant Enterobacterales infection. |
