ReviewCureus2025
The Safety and Efficacy of Ceftazidime-Avibactam Plus Metronidazole Versus Meropenem for Intra-abdominal Infections: A Systematic Review and Meta-Analysis.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Novel Therapeutic Approaches and Alternatives to Antibiotic Therapy for Drug-Resistant Intra-Abdominal Infections.Antibiotics (Basel, Switzerland) · 2026Review
- Antibiotics for Intra-Abdominal Infections: When, Which, How and How Long?Antibiotics (Basel, Switzerland) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Intra-abdominal infections encompass a range of medical conditions categorized by their complexity. Uncomplicated infections involve inflammation or infection limited to a single abdominal organ, such as acute appendicitis or cholecystitis, without extending to the peritoneum, while complicated infections spread to the peritoneal cavity. The key associated microbiological agents include Gram-positive cocci, Gram-negative Enterobacteriaceae, and obligate anaerobes, with common pathogens being Escherichia coli, Klebsiella pneumoniae, Streptococcus species, and Bacteroides fragilis. Treatment options include well-established antibiotics and newer agents like meropenem, metronidazole, and ceftazidime/avibactam. Meropenem, a carbapenem antibiotic, is known for its broad-spectrum efficacy and low toxicity, making it suitable for severe infections. Ceftazidime, a third-generation cephalosporin, is effective against Pseudomonas aeruginosa, especially when paired with avibactam, a β-lactamase inhibitor, enhancing its effectiveness. Metronidazole disrupts bacterial DNA, targeting anaerobic bacteria and protozoa. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of the ceftazidime-avibactam plus metronidazole combination compared to meropenem for intra-abdominal infections. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, a comprehensive search of databases such as PubMed, Web of Science, and the Cochrane Library was conducted. Results showed that the combination therapy had a slightly higher overall adverse event rate (5.57%) compared to meropenem (4.56%), although this difference was not statistically significant [risk ratio (RR): 1.22; 95% confidence interval (CI): 0.78-1.93; p = 0.39]. Meropenem demonstrated a significantly higher clinical response rate in ceftazidime-susceptible infections (89.93% vs. 85.88%; RR: 0.96; 95% CI: 0.93-0.99; p = 0.009). No significant differences were observed in ceftazidime-resistant infections. Overall, the findings suggest that ceftazidime-avibactam combined with metronidazole is a viable alternative to meropenem, highlighting the need for further research to optimize treatment strategies amid rising antibiotic resistance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.