Ceftolozane-tazobactam (C/T) is a combination of an advanced-generation cephalosporin (ceftolozane) with a β-lactamase inhibitor (tazobactam). It is approved for the treatment of complicated urinary-tract/intra-abdominal infections and hospital-acquired/ventilator-associated pneumonia. This systematic review and meta-analysis (registered prospectively on PROSPERO, no. CRD42019134099, on 20 January 2020) aimed to evaluate the effectiveness of C/T combination therapy compared to C/T monotherapy for the treatment of severe infections and to describe the prevalence of microorganisms in the included studies. We retrieved literature from PubMed, EMBASE, and CENTRAL, until 26 November 2020. Eligible studies were both randomised trials and nonrandomised studies with a control group, published in the English language and peer-reviewed journals. The primary outcome was all-cause mortality; secondary outcomes were (i) clinical improvement and (ii) microbiological cure. Eight nonrandomised studies were included in the qualitative synthesis: Seven retrospective cohort studies and one case-control study. The meta-analysis of the four studies evaluating all-cause mortality (in total 148 patients: 87 patients treated with C/T alone and 61 patients treated with C/T combination therapy) showed a significant reduction of mortality in patients receiving C/T combination therapy, OR: 0.31, 95% CI: 0.10–0.97, p = 0.045. Conversely, the meta-analysis of the studies evaluating clinical improvement and microbiological cure showed no differences in C/T combination therapy compared to C/T monotherapy. The most consistent data come from the analysis of the clinical improvement, n = 391 patients, OR: 0.97, 95% CI: 0.54–1.74, p = 0.909. In 238 of the 391 patients included (60.8%), C/T was used for the treatment of infections caused by Pseudomonas aeruginosa.

中文翻译：

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头孢唑烷-他唑巴坦单药联合治疗与头孢唑烷-他唑巴坦单药治疗重度感染的比较：系统评价和荟萃分析

头孢唑烷他唑巴坦（C / T）是新一代头孢菌素（头孢唑烷）与β-内酰胺酶抑制剂（他唑巴坦）的组合。它被批准用于治疗复杂的尿路/腹腔内感染和医院获得/呼吸机相关性肺炎。该系统评价和荟萃分析（前瞻性注册于2020年1月20日于PROSPERO，编号CRD42019134099）旨在评估C / T联合疗法与C / T单一疗法相比在治疗严重感染中的有效性，并描述患病率纳入研究中的微生物数量。我们检索了PubMed，EMBASE和CENTRAL直至2020年11月26日的文献。符合条件的研究包括随机试验和对照组的非随机研究，均以英语和同行评审期刊发表。主要结果是全因死亡率。次要结果是（i）临床改善和（ii）微生物学治愈。定性综合包括八项非随机研究：七项回顾性队列研究和一项病例对照研究。对四项评估全因死亡率的研究进行的荟萃分析（总共148例患者：87例接受C / T单独治疗的患者和61例接受C / T联合疗法治疗的患者）显示接受C / T的患者死亡率显着降低联合疗法，或：0.31，95％CI：0.10–0.97，p＝ 0.045。相反，评估临床改善和微生物治愈的研究的荟萃分析显示，与C / T单一疗法相比，C / T联合疗法没有差异。最一致的数据来自对临床改善的分析，n = 391例患者，或：0.97，95％CI：0.54-1.74，p = 0.909。在391名患者中有238名患者（占60.8％）中，C / T用于治疗由铜绿假单胞菌引起的感染。