Clinical effectiveness of new antibiotics similar to carbape
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The clinical effectiveness of new antibiotics was similar compared with carbapenems for treating complicated UTIs, although the new treatments demonstrated a better microbiological response, researchers reported.

The findings are from a systematic review and meta-analysis published in Open Forum Infectious Diseases.

“Having performed the MERINO trial where meropenem had excellent results, the trial results coming in on plazomicin, cefiderocol, etc., were quite a shock,” authors said. “Therefore, we felt there was a need to systematically review the randomized trial data on new antibiotics compared to carbapenems.”

The systematic review and meta-analysis evaluated the clinical efficacy and safety of carbapenems for the treatment of cUTIs with the comparators being new antibiotics evaluated for this indication, including cefiderocol, plazomicin and eravacycline. The analysis included six randomized controlled trials with a total of 3,343 subjects.

According to the researchers, the pooled efficacy estimates of composite cure favored new antibiotics, although the difference was not statistically significant. Additionally, the pooled estimate examining clinical response alone showed no difference between treatment arms, although new antibiotic treatments were superior to carbapenems in terms of microbiological response.

“We feel it is likely that drugs with antianaerobic activity, like carbapenems, have a deleterious effect on the vaginal flora. This may predispose a patient to microbiologic recurrence,” the author said. “This effect of antibiotics on the vaginal microbiome needs to be prospectively evaluated to determine if its significance extends to other drugs which act on the anaerobic flora, including amoxicillin/clavulanate and piperacillin/tazobactam.”