Piperacillin/tazobactam, Imipenem/cilastatin, Pneumonia
Efficacy and safety of piperacillin/tazobactam versus imipenem/cilastatin therapy for pneumonia: a meta-analysis of randomized controlled trials
Authors: Guoming Su 1, 2, Zuguo Zhao 3, Weiqing Yang 2*
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Piperacillin/tazobactam with its broad spectrum of antibacterial activity was used widely for the treatment of polymicrobial infections. The aim of this study was to compare the efficacy and safety of piperacillin/tazobactam with imipenem/cilastatin for pneumonia. We performed a literature search to identify studies that investigated the effects of randomized controlled trials on piperacillin/tazobactam versus imipenem/cilastatin. The primary study end-points were clinical and microbiological treatment success and treatment-related adverse events. Data analysis was performed by using Review Manager 5.2 software. Four randomized controlled trials met the inclusion criteria. Odds ratio (95% confidence interval (CI)) of clinical treatment success based on clinically evaluable population for patients treated with piperacillin/tazobactam compared with that of imipenem/cilastatin was 1.44 (0.96–2.16); odds ratio (95% CI) of microbiological treatment success based on microbiologically evaluable population for patients treated with piperacillin/tazobactam compared to that of imipenem/cilastatin was 1.58 (0.45–5.56); odds ratio (95% CI) of clinical and microbiological treatment success based on intention to treat population for patients treated with piperacillin/tazobactam compared with imipenem/cilastatin was respectively 1.03 (0.77–1.38) and 0.67 (0.42–1.09); odds ratio (95% CI) of treatment-related adverse events for pneumonia patients treated with piperacillin/tazobactam compared to that of imipenem/cilastatin was 1.10 (0.77–1.59). This meta-analysis provides that piperacillin/tazobactam can be used as safe and efficacious as imipenem/cilastatin in treating hospitalized patients with pneumonia. It is an appealing option for the treatment of severe pneumonia, especially nosocomially acquired pneumonia.