Objective

Both ertapenem and other carbapenems, including imipenem, meropenem, and doripenem, are recommended in the treatment of extended-spectrum-β-lactamase (ESBL)-producing Enterobacterales infection. However, whether ertapenem is as effective as other carbapenems for ESBL-producing Enterobacterales remains unclear. Therefore, this meta-analysis was conducted to compare the clinical efficacy of ertapenem versus other carbapenems in the treatment of ESBL-producing Enterobacterales infection.

Methods

PubMed, Web of Science, and Cochrane Library were searched from their inception to 29 November 2022. Only studies comparing ertapenem and other carbapenems in the treatment of patients with ESBL-producing Enterobacterales infections were included.

Results

A total of six studies meeting selection criteria were identified. Overall, ertapenem was associated with a significantly lower 30-d mortality when compared with other carbapenems (10.7% [46/431] vs. 17.7% [104/586]; risk ratio [RR], 0.61; 95% CI: 0.40–0.91). The ertapenem group exhibited a significantly shorter length of hospital stay than the other carbapenem groups (mean differences, -6.02 d; 95% CI, -9.39 to -2.64). No significant differences were noted between ertapenem and other carbapenem groups in terms of rates of clinical cure or improvement (RR, 1.11; 95% CI: 0.97–1.25) and microbiological eradication (RR, 1.01; 95% CI: 0.97–1.06).

Conclusions

Ertapenem could be as effective as other carbapenems in the treatment of patients with ESBL-producing Enterobacterales infections.

中文翻译：

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厄他培南与其他碳青霉烯类药物治疗产广谱β-内酰胺酶肠杆菌感染的临床疗效：系统评价和荟萃分析

客观的

厄他培南和其他碳青霉烯类，包括亚胺培南、美罗培南和多尼培南，均被推荐用于治疗产生超广谱β-内酰胺酶（ESBL）的肠杆菌感染。然而，对于产 ESBL肠杆菌，厄他培南是否与其他碳青霉烯类一样有效仍不清楚。因此，本荟萃分析旨在比较厄他培南与其他碳青霉烯类药物治疗产 ESBL肠杆菌感染的临床疗效。

方法

PubMed、Web of Science 和 Cochrane 图书馆的检索时间从最初到 2022 年 11 月 29 日。仅纳入比较厄他培南和其他碳青霉烯类药物治疗产 ESBL 肠杆菌感染患者的研究。

结果

总共确定了六项符合选择标准的研究。总体而言，与其他碳青霉烯类药物相比，厄他培南的 30 天死亡率显着降低（10.7% [46/431] vs. 17.7% [104/586]；风险比 [RR]，0.61；95% CI：0.40– 0.91）。厄他培南组的住院时间明显短于其他碳青霉烯组（平均差异，-6.02 天；95% CI，-9.39 至 -2.64）。厄他培南和其他碳青霉烯组在临床治愈或改善率（RR，1.11；95% CI：0.97-1.25）和微生物根除率（RR，1.01；95% CI：0.97-1.06）方面没有显着差异。

结论

厄他培南在治疗产 ESBL肠杆菌感染患者方面与其他碳青霉烯类一样有效。