Summary

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• This summary is based on the review of 18 systematic review(s)/meta-analysis(es). ^[1-18]
• Mortality and Clinical Cure Rates in Nosocomial Infections: Ceftazidime/avibactam demonstrated lower mortality rates (odds ratio (OR) 2.73, 95% confidence interval (CI) 1.59-4.69) and higher clinical cure rates compared to polymyxin B in patients with multidrug-resistant infections, including carbapenem-resistant Enterobacterales (CRE).
• Efficacy in Nosocomial Pneumonia: Ceftazidime/avibactam showed a lower clinical failure rate than ceftazidime alone (OR = 1.48, 95% CrI [1.02-2.20]), though no significant difference in 28-day mortality was observed among beta-lactam regimens.
• Effectiveness in Complicated Intra-Abdominal Infections (cIAI): While ceftazidime/avibactam combined with metronidazole had higher adverse event-related discontinuations compared to meropenem, eravacycline showed improved microbiological response rates over tigecycline in cIAI.
• CRE and Multidrug-Resistant Infections: Ceftazidime/avibactam demonstrated lower mortality and higher clinical cure rates compared to colistin-based therapies in CRE infections, with synergistic effects noted when combined with agents such as aztreonam and amikacin.
• Adverse Events and Discontinuations: Ceftazidime/avibactam, when combined with metronidazole, showed higher discontinuation rates due to adverse events compared to meropenem in complicated intra-abdominal infections (cIAI).
• Nephrotoxicity: Ceftazidime/avibactam demonstrated lower nephrotoxicity rates than colistin-based regimens and polymyxin B, indicating a favorable nephrotoxicity profile compared to these alternatives in treating CRE and multidrug-resistant infections.
• Resistance Development: Emergence of resistance to ceftazidime/avibactam was observed, particularly in Klebsiella pneumoniae carbapenemase (KPC)-producing strains, suggesting a notable risk in prolonged or specific clinical contexts.
• Ceftazidime/avibactam demonstrated reduced mortality and higher clinical cure rates in the general population with nosocomial infections, showed favorable efficacy and safety profiles in newborns and pediatric patients with multidrug-resistant infections, and was effective in treating CRE infections with a lower nephrotoxicity risk compared to colistin-based regimens.