The efficacy and safety of ceftaroline in the treatment of acute bacterial infection in pediatric patients – a systemic review and meta-analysis of randomized controlled trials

摘要

Objectives: This meta-analysis aims to assess the clinical efficacy and safety of ceftaroline in treating acute bacterial infections – community-acquired pneumonia (CAP) and skin and skin structure infection (SSSI) in pediatric patients. Methods: The Pubmed, Embase, ClinicalTrials.gov. and the Cochrane databases were searched up to December 31, 2018. Only randomized controlled trials (RCTs) evaluating ceftaroline and other comparators in the treatment of acute bacterial infection in pediatric patients were included. The primary outcome was the clinical cure rate and the secondary outcome was the risk of adverse event. Results: Three RCTs were included. Overall, ceftaroline had a clinical cure rate at end of therapy (EOT) and test of cure (TOC) similar to comparators in the treatment of acute bacterial infection (at EOT, OR, 1.93; 95% CI, 0.88–4.25, Isup2/sup =0%, and at TOC, OR, 1.36; 95% CI, 0.64–2.91, Isup2/sup =14%). In addition, ceftaroline had a clinical failure rate at EOT and TOC similar to comparators in the treatment of acute bacterial infection (at EOT, OR, 0.62; 95% CI, 0.22–1.76, Isup2/sup =0%, and at TOC, OR, 0.68; 95% CI, 0.24–1.91, Isup2/sup =0%). No significant differences were found for the risk of treatment-emergent adverse events (TEAE) in all and different degrees between ceftaroline and comparators (OR, 0.81; 95% CI, 0.37–1.78, Isup2/sup =56%). The risks of TEAE and severe adverse events related to study drug were similar between ceftaroline and comparators (TEAE related to study drug, OR, 0.98; 95% CI, 0.52–1.82, Isup2/sup =0%, severe adverse event related to study drug, OR, 1.09; 95% CI, 0.22–5.44, Isup2/sup =22%). Conclusions: The clinical efficacy of ceftaroline is as good as comparator therapy in the treatment of acute bacterial infections – CAP and SSSI, and this antibiotic is well tolerated as the comparators.