A meta-analysis of efficacy and safety of doripenem for treating bacterial infections.

objectiveThe aim of this article is to compare the efficacy and safety of doripenem for bacterial infections.

methodsWe included six randomized clinical trials identified from PubMed and Embase up to July 31, 2014. The included trials compared efficacy and safety of doripenem for complicated intra-abdominal infections, complicated urinary tract infection, nosocomial pneumonia, and acute biliary tract infection. The meta-analysis was carried on by the statistical software of Review Manager, version 5.2.

resultsCompared with empirical antimicrobial agents on overall treatment efficacy, doripenem was associated with similar clinical and microbiological treatment success rates (for the clinical evaluable population, odds ratio [OR]=1.26, 95% confidence interval [CI] 0.93-1.69, p=0.13; for clinical modified intent-to-treatment population, OR=0.88, 95% CI 0.55-1.41, p=0.60; for microbiology evaluable population, OR=1.16, 95% CI 0.90-1.50, p=0.26; for microbiological modified intent-to-treatment (m-mITT), OR=0.98, 95% CI 0.81-1.20, p=0.87). We compared incidence of adverse events and all-cause mortality to analyze treatment safety. The outcomes suggested that doripenem was similar to comparators in terms of incidence of adverse events and all-cause mortality on modified intent-to-treatment population (for incidence of AEs, OR=1.10, 95% CI 0.90-1.35, p=0.33; for all-cause mortality, OR=1.08, 95% CI 0.77-1.51, p=0.67). In nosocomial pneumonia and ventilator-associated pneumonia treatment, doripenem was not inferior to other antibacterial agents in terms of efficacy and safety.

conclusionFrom this meta-analysis, we can conclude that doripenem is as valuable and well-tolerated than empirical antimicrobial agents for complicated intra-abdominal infections, complicated urinary tract infection, acute biliary tract infection and nosocomial pneumonia treatment.