Nosocomial pneumonia: ceftolozane-tazobactam vs meropenem

  • Kollef MH & al.
  • Lancet Infect Dis
  • 25 Sep 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In critically ill patients with nosocomial pneumonia, high-dose ceftolozane-tazobactam was non-inferior to meropenem in terms of 28-day mortality and clinical response.

Why this matters

  • Findings suggest that high-dose ceftolozane-tazobactam can be used for the treatment of nosocomial pneumonia caused by P aeruginosa, Enterobacteriaceae, and other Gram-negative lower respiratory tract pathogens.

Study design

  • Patients with nosocomial pneumonia were randomly assigned to receive ceftolozane-tazobactam (3 g; n=361) and meropenem (1 g; n=359).
  • Primary outcome: 28-day all-cause mortality.
  • Secondary outcome: clinical response at the test-of-cure visit.
  • Funding: MSD.

Key results

  • Overall, 519 (71.50%) patients had ventilator-associated pneumonia, 207 (28.5%) had ventilated hospital-acquired pneumonia, 239 (33%) had Acute Physiology and Chronic Health Evaluation II scores ≥20 and 668 (92%) were in the intensive care unit.
  • Ceftolozane-tazobactam was non-inferior to meropenem in terms of:
    • 28-day all-cause mortality (24.0% vs 25.3%; weighted treatment difference, 1.1%; 95% CI, −5.1 to 7.4).
    • clinical response at the test-of-cure visit (54.4% vs 53.3%; weighted treatment difference, 1.1%; 95% CI, −6.2 to 8.3).
  • Treatment-related adverse events were reported in 38 (11%) patients in the ceftolozane-tazobactam group and 27 (8%) in the meropenem group.
  • Serious treatment-related adverse events occurred in 8 (2%) patients in the ceftolozane-tazobactam group and 2 (1%) in the meropenem group.
  • No treatment-related deaths were reported in both groups.

Limitations

  • Immunosuppressed patients, patients with cystic fibrosis and those receiving dialysis were excluded.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit