Ceftaroline Efficacy and Safety in Treatment of Complicated Skin and Soft Tissue Infection: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

Shao-Huan Lan; Shen-Peng Chang; Chih-Cheng Lai; Li-Chin Lu; Chien-Ming Chao

doi:10.3390/jcm8060776

Ceftaroline Efficacy and Safety in Treatment of Complicated Skin and Soft Tissue Infection: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

J Clin Med. 2019 May 31;8(6):776. doi: 10.3390/jcm8060776.

Authors

Shao-Huan Lan¹, Shen-Peng Chang², Chih-Cheng Lai³, Li-Chin Lu⁴, Chien-Ming Chao⁵

Affiliations

¹ School of Pharmaceutical Sciences and Medical Technology, Putian University, Putian 351100, China. shawnlan0713@gmail.com.
² Department of Pharmacy, Chi Mei Medical Center, Liouying 73657, Taiwan. httremoon@ms.szmc.edu.tw.
³ Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan. dtmed141@gmail.com.
⁴ School of Management, Putian University, Putian 351100, China. jane90467@gmail.com.
⁵ Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan. ccm870958@yahoo.com.tw.

Abstract

This study aims to assess the clinical efficacy and safety of ceftaroline for the treatment of complicated skin and skin structure infections (cSSSIs) in adult patients through meta-analysis. PubMed, Embase, ClinicalTrials.gov, and Cochrane databases were searched up to April 2019. Only randomized controlled trials (RCTs) that evaluated ceftaroline and other comparators for treating cSSSIs in adult patients were included. The primary outcome was the clinical cure rate, whereas the secondary outcomes were clinical failure rate, microbiological eradication rate, relapse rate, and risk of an adverse event (AE). Five RCTs were included. Overall, ceftaroline had a clinical cure rate similar to comparators in the treatment of cSSSIs in the modified intent-to-treat population (risk ratio (RR), 1.00; 95% confidence interval (CI), 0.97-1.04; I² = 0%) and in the clinically evaluable population (RR, 1.00; 95% CI, 0.97-1.03; I² = 0%). In addition, no significant difference was observed between ceftaroline and comparators for the treatment of infection with Staphylococcus aureus (RR, 1.01; 95% CI, 0.98-1.05; I² = 0%), methicillin-resistant S. aureus (RR, 0.99; 95% CI, 0.94-1.05; I² = 0%), methicillin-susceptible S. aureus (RR, 1.01; 95% CI, 0.96-1.06; I² = 26%), Streptococcus spp. (RR, 1.07; 95% CI, 0.92-1.24; I² = 73%), and Gram-negative bacteria (RR, 0.94; 95% CI, 0.83-1.08; I² = 0%). Furthermore, ceftaroline had a similar rate of microbiological eradication (92.2% vs. 92.6%, RR, 1.00; 95% CI, 0.97-1.03; I² = 9%) and relapse (6.9% vs. 9.1%, RR, 0.48; 95% CI, 0.14-1.74; I² = 0%) as comparators. Finally, the risks of treatment-emergent AEs (RR, 0.96; 95% CI, 0.88-1.05; I² = 0%), serious AEs (RR, 1.03; 95% CI, 0.63-1.68; I² = 0%), and discontinuation of study drug due to an AE (RR, 0.86; 95% CI, 0.50-1.49; I² = 34%) did not differ significantly between ceftaroline and comparators. In conclusion, the clinical efficacy of ceftaroline is as high as that of comparators in the treatment of cSSSIs in adult patients, and this antibiotic is well tolerated like the comparators.

Keywords: ceftaroline; complicated skin and skin structure infection; methicillin-resistant Staphylococcus aureus; vancomycin.