Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2009

Open Access 01-12-2009 | Research article

Ertapenem versus piperacillin/tazobactam for the treatment of complicated infections: a meta-analysis of randomized controlled trials

Authors: Mao Mao An, Zui Zou, Hui Shen, Jun Dong Zhang, Meng Li Chen, Ping Liu, Rui Wang, Yuan Ying Jiang

Published in: BMC Infectious Diseases | Issue 1/2009

Login to get access

Abstract

Background

Ertapenem, a new carbapenem with a favorable pharmacokinetic profile, has been approved for the treatment of complicated intra-abdominal Infections (cIAIs), acute pelvic infections (APIs) and complicated skin and skin-structure infections (cSSSIs). The aim of this study is to compare the efficacy and safety of ertapenem with piperacillin/tazobactam, which has been reported to possess good efficacy for the treatment of these complicated infections.

Methods

We performed a meta-analysis of randomized controlled trials identified in PubMed, Cochrane library and Embase that compared the efficacy and safety of ertapenem with piperacillin/tazobactam for the treatment of complicated infections including cIAIs, APIs, cSSSIs. The primary efficacy outcome was clinical treatment success assessed at the test-of-cure visit. The primary safety outcome was drug related clinical and laboratory adverse events occurred during the treatment and the post-treatment period.

Result

Six RCTs, involving 3161 patients, were included in our meta-analysis. Ertapenem was associated similar clinical treatment success with piperacillin/tazobactam for complicated infections treatment (clinically evaluable population, 1937 patients, odds ratios: 1.15, 95% confidence intervals: 0.89-1.49; modified intention to treat population, 2855 patients, odds ratios: 1.03, 95% confidence intervals: 0.87-1.22). All of secondary efficacy outcomes analysis obtained similar findings with clinical treatment success. No difference was found about the incidence of drug related adverse events between ertapenem and piperacillin/tazobactam groups.

Conclusion

This meta-analysis provides evidence that ertapenem 1 g once a day can be used as effectively and safely as recommended dose of piperacillin/tazobactam, for the treatment of complicated infections, particularly of mild to moderate severity. It is an appealing option for the treatment of these complicated infections.
Appendix
Available only for authorised users
Literature
1.
Sawyer MD, Dunn DL: Antimicrobial therapy of intra-abdominal sepsis. Infect Dis Clin North Am. 1992, 6: 545-570.PubMed
2.
Hemsell DL, Solomkin JS, Sweet R, Tally F, Bartlett JG: Evaluation of new anti-infective drugs for the treatment of acute pelvic infections in hospitalized women. Clin Infect Dis. 1992, 15: S43-52.CrossRefPubMed
3.
Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan EL, Montoya JG, Wade JC: Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005, 41: 1373-1406. 10.1086/497143.CrossRefPubMed
4.
Lipsky BA: A report from the international consensus on diagnosing and treating the infected diabetic foot. Diabetes Metab Res Rev. 2004, 20: S68-77. 10.1002/dmrr.453.CrossRefPubMed
5.
Mazuski JE, Sawyer RG, Nathens AB, DiPiro JT, Schein M, Kudsk KA, Yowler C: The Surgical Infection Society guidelines on antimicrobial therapy for intra-abdominal infections: Evidence for the recommendations. Surg Infect (Larchmt). 2002, 3: 175-233. 10.1089/109629602761624180.CrossRef
6.
Solomkin JS, Mazuski JE, Baron EJ, Sawyer RG, Nathens AB, DiPiro JT, Buchman T, Dellinger EP, Jernigan J, Gorbach S, Chow AW, Bartlett J: Guidelines for the selection of anti-infective agents for complicated intra-abdominal infections. Clin Infect Dis. 2003, 37: 997-1005. 10.1086/378702.CrossRefPubMed
7.
Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan EL, Montoya JG, Wade JC: Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005, 41: 1373-1406. 10.1086/497143.CrossRefPubMed
8.
Livermore DM, Carter MW, Bagel S, Wiedemann B, Baquero F, Loza E, Endtz HP, Braak van Den N, Fernandes CJ, Fernandes L, Frimodt-Moller N, Rasmussen LS, Giamarellou H, Giamarellos-Bourboulis E, Jarlier V, Nguyen J, Nord CE, Struelens MJ, Nonhoff C, Turnidge J, Bell J, Zbinden R, Pfister S, Mixson L, Shungu DL: In vitro activities of ertapenem (MK-0826) against recent clinical bacteria collected in Europe and Australia. Antimicrob Agents Chemother. 2001, 45: 1860-1867. 10.1128/AAC.45.6.1860-1867.2001.CrossRefPubMedPubMedCentral
9.
Fuchs PC, Barry AL, Brown SD: In vitro activities of ertapenem (MK-0826) against clinical bacterial isolates from 11 North American medical centers. Antimicrob Agents Chemother. 2001, 45: 1915-1918. 10.1128/AAC.45.6.1915-1918.2001.CrossRefPubMedPubMedCentral
10.
Goldstein EJ, Citron DM, Vreni Merriam C, Warren Y, Tyrrell KL: Comparative in vitro activities of ertapenem (MK-0826) against 1,001 anaerobes isolated from human intra-abdominal infections. Antimicrob Agents Chemother. 2000, 44: 2389-2394. 10.1128/AAC.44.9.2389-2394.2000.CrossRefPubMedPubMedCentral
11.
Dela Pena AS, Asperger W, Köckerling F, Raz R, Kafka R, Warren B, Shivaprakash M, Vrijens F, Giezek H, DiNubile MJ, Chan CY: Efficacy and safety of ertapenem versus piperacillin/tazobactam for the treatment of intra-abdominal infections requiring surgical intervention. J Gastrointest Surg. 2006, 10: 567-574. 10.1016/j.gassur.2005.06.015.CrossRefPubMed
12.
Namias N, Solomkin JS, Jensen EH, Tomassini JE, Abramson MA: Randomized, multicenter, double-blind study of efficacy, safety, and tolerability of intravenous ertapenem versus piperacillin/tazobactam in treatment of complicated intra-abdominal infections in hospitalized adults. Surg Infect (Larchmt). 2007, 8: 15-28. 10.1089/sur.2006.030.CrossRef
13.
Roy S, Higareda I, Angel-Muller E, Ismail M, Hague C, Adeyi B, Woods GL, Teppler H: Ertapenem once a day versus piperacillin-tazobactam every 6 hours for treatment of acute pelvic infections: a prospective, multicenter, randomized, double-blind study. Infect Dis Obstet Gynecol. 2003, 11: 27-37. 10.1155/S1064744903000048.CrossRefPubMedPubMedCentral
14.
Solomkin JS, Yellin AE, Rotstein OD, Christou NV, Dellinger EP, Tellado JM, Malafaia O, Fernandez A, Choe KA, Carides A, Satishchandran V, Teppler H: Ertapenem versus piperacillin/tazobactam in the treatment of complicated intra abdominal infections: results of a double-blind, randomized comparative phase III trial. Ann Surg. 2003, 237: 235-245. 10.1097/00000658-200302000-00013.PubMedPubMedCentral
15.
Graham DR, Lucasti C, Malafaia O, Nichols RL, Holtom P, Perez NQ, McAdams A, Woods GL, Ceesay TP, Gesser R: Ertapenem once daily versus piperacillin-tazobactam 4 times per day for treatment of complicated skin and skin-structure infections in adults: results of a prospective, randomized, double-blind multicenter study. Clin Infect Dis. 2002, 34: 1460-1468. 10.1086/340348.CrossRefPubMed
16.
Lipsky BA, Armstrong DG, Citron DM, Tice AD, Morgenstern DE, Abramson MA: Ertapenem versus piperacillin/tazobactam for diabetic foot infections (SIDESTEP): prospective, randomised, controlled, double-blinded, multicentre trial. Lancet. 2005, 366: 1695-1703. 10.1016/S0140-6736(05)67694-5.CrossRefPubMed
17.
Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ: Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996, 17: 1-12. 10.1016/0197-2456(95)00134-4.CrossRefPubMed
18.
Khan KS, Daya S, Jadad A: The importance of quality of primary studies in producing unbiased systematic reviews. Arch Intern Med. 1996, 156: 661-666. 10.1001/archinte.156.6.661.CrossRefPubMed
19.
Moher D, Jadad AR, Tugwell P: Assessing the quality of randomized controlled trials. Current issues and future directions. Int J Technol Assess Health Care. 1996, 12: 195-208. 10.1017/S0266462300009570.CrossRefPubMed
20.
Solomkin J, Teppler H, Graham DR, Gesser RM, Meibohm AR, Roy S, Woods GL: Treatment of polymicrobial infections: post hoc analysis of three trials comparing ertapenem and piperacillin/tazobactam. J Antimicrob Chemother. 2004, 53: ii51-57. 10.1093/jac/dkh206.CrossRefPubMed
21.
Falagas ME, Peppas G, Makris GC, Karageorgopoulos DE, Matthaiou DK: Meta-analysis: ertapenem for complicated intra-abdominal infections. Aliment Pharmacol Ther. 2008, 27: 919-931. 10.1111/j.1365-2036.2008.03642.x.CrossRefPubMed
22.
Gin A, Dilay L, Karlowsky JA, Walkty A, Rubinstein E, Zhanel GG: Piperacillin/tazobactam: a beta-lactam/beta-lactamase inhibitor combination. Anti Infect Ther. 2007, 5: 365-383. 10.1586/14787210.5.3.365.CrossRef
23.
Teppler H, McCarroll K, Gesser RM, Woods GL: Surgical infections with Enterococcus: outcome in patients treated with ertapenem versus piperacillin-tazobactam. Surg Infect (Larchmt). 2002, 4: 337-349. 10.1089/109629602762539553.CrossRef
24.
Barie PS: Enterococcus in perspective. Surg Infect (Larchmt). 2000, 1: 91-93. 10.1089/109629600321128.CrossRef
25.
Lipsky BA, Pecoraro RE, Larson SA, Hanley ME, Ahroni JH: Outpatient management of uncomplicated lower-extremity infections in diabetic patients. Arch Intern Med. 1990, 150: 790-797. 10.1001/archinte.150.4.790.CrossRefPubMed
26.
Cunha BA: Antibiotic selection for diabetic foot infections: a review. J Foot Ankle Surg. 2000, 39: 253-257. 10.1016/S1067-2516(00)80009-5.CrossRefPubMed
27.
File TM, Tan JS: Amdinocillin plus cefoxitin versus cefoxitin alone in therapy of mixed soft tissue infections (including diabetic foot infections). Am J Med. 1983, 75: 100-105. 10.1016/0002-9343(83)90103-1.CrossRefPubMed
28.
Mazuski JE, Sawyer RG, Nathens AB, DiPiro JT, Schein M, Kudsk KA, Yowler C: The Surgical Infection Society Guidelines on antimicrobial therapy for intra-abdominal infections: An executive summary. Surg Infect (Larchmt). 2002, 3: 161-173. 10.1089/109629602761624171.CrossRef
29.
Solomkin JS, Mazuski JE, Baron EJ, Sawyer RG, Nathens AB, DiPiro JT, Buchman T, Dellinger EP, Jernigan J, Gorbach S, Chow AW, Bartlett J: Guidelines for the selection of anti-infective agents for complicated intra-abdominal infections. Clin Infect Dis. 2003, 37: 997-1005. 10.1086/378702.CrossRefPubMed
30.
Dinubile MJ, Friedland I, Chan CY, Motyl MR, Giezek H, Shivaprakash M, Weinstein RA, Quinn JP: Bowel colonization with resistant gram-negative bacilli after antimicrobial therapy of intra-abdominal infections: Observations from two randomized comparative clinical trials of ertapenem therapy. Eur J Clin Microbiol Infect Dis. 2005, 24: 443-449. 10.1007/s10096-005-1356-0.CrossRefPubMed
31.
DiNubile MJ, Chow JW, Satishchandran V, Polis A, Motyl MR, Abramson MA, Teppler H: Acquisition of resistant bowel flora during a double blind randomized clinical trial of ertapenem versus piperacillin/tazobactam therapy for intraabdominal infections. Antimicrob Agents Chemother. 2005, 49: 3217-3221. 10.1128/AAC.49.8.3217-3221.2005.CrossRefPubMedPubMedCentral
32.
Zhanel GG, Johanson C, Embil JM, Noreddin A, Gin A, Vercaigne L, Hoban DJ: Ertapenem: Review of a new carbapenem. Expert Rev Anti Infect Ther. 2005, 3: 23-39. 10.1586/14787210.3.1.23.CrossRefPubMed
33.
Tice AD, Turpin RS, Hoey CT, Lipsky BA, Wu J, Abramson MA: Comparative costs of ertapenem and piperacillin-tazobactam in the treatment of diabetic foot infections. Am J Health Syst Pharm. 2007, 64: 1080-1086.PubMed
Metadata
Title
Ertapenem versus piperacillin/tazobactam for the treatment of complicated infections: a meta-analysis of randomized controlled trials
Authors
Mao Mao An
Zui Zou
Hui Shen
Jun Dong Zhang
Meng Li Chen
Ping Liu
Rui Wang
Yuan Ying Jiang
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2009
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-9-193

Other articles of this Issue 1/2009

BMC Infectious Diseases 1/2009 Go to the issue

Technical advance

Barriers to the care of HIV-infected children in rural Zambia: a cross-sectional analysis

Research article

Identification and validation of clinical predictors for the risk of neurological involvement in children with hand, foot, and mouth disease in Sarawak

Research article

Modulations of cell cycle checkpoints during HCV associated disease

Research article

Drug-resistance in Streptococcus pneumoniae isolates among Spanish middle aged and older adults with community-acquired pneumonia

Research article

Truncation in the tcdC region of the Clostridium difficilePathLoc of clinical isolates does not predict increased biological activity of Toxin B or Toxin A

Research article

Low density parasitaemia, red blood cell polymorphisms and Plasmodium falciparumspecific immune responses in a low endemic area in northern Tanzania
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits