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URL Address
<a href="http://doi.org/10.1093/jac/dkv415" target="_blank" rel="noreferrer noopener">http://doi.org/10.1093/jac/dkv415</a>
Pages
862–870
Issue
4
Volume
71
Dublin Core
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Title
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Ceftaroline fosamil versus ceftriaxone for the treatment of community-acquired pneumonia: individual patient data meta-analysis of randomized controlled trials.
Publisher
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The Journal of antimicrobial chemotherapy
Date
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2016
2016-04
Subject
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Anti-Bacterial Agents/*therapeutic use; Bacterial/*drug therapy; Ceftriaxone/*therapeutic use; Cephalosporins/*therapeutic use; Community-Acquired Infections/*drug therapy; Humans; Pneumonia; Randomized Controlled Trials as Topic
Creator
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Taboada Maria; Melnick David; Iaconis Joseph P; Sun Fang; Zhong Nan Shan; File Thomas M; Llorens Lily; Friedland H David; Wilson David
Description
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BACKGROUND: We conducted a meta-analysis of clinical trials of adults hospitalized with pneumonia outcomes research team (PORT) risk class 3-4 community-acquired pneumonia (CAP) receiving ceftaroline fosamil versus ceftriaxone. METHODS: Three Phase III trials (clinicaltrials.gov registration numbers NCT00621504, NCT00509106 and NCT01371838) including 1916 hospitalized patients with CAP randomized 1:1 to empirical ceftaroline fosamil (600 mg every 12 h) or ceftriaxone (1-2 g every 24 h) for 5-7 days were included in the meta-analysis. Primary outcome was clinical response at the test-of-cure visit (8-15 days after end of treatment) in the PORT risk class 3-4 modified ITT (MITT) and clinically evaluable (CE) populations. Data were tested for heterogeneity (chi(2) test) and, if not significant, results were pooled and OR and 95% CI constructed. A logistic regression analysis assessed factors impacting cure rate and treatment interactions. RESULTS: Clinical cure rates in each trial consistently favoured ceftaroline fosamil versus ceftriaxone, with no evidence of heterogeneity. In the meta-analysis, ceftaroline fosamil was superior to ceftriaxone in the MITT (OR: 1.66; 95% CI 1.34, 2.06; P \textless 0.001) and CE (OR: 1.65; 95% CI 1.26, 2.16; P \textless 0.001) populations. Results were consistent across various patient- and disease-related factors including patients' age and PORT score. Prior antimicrobial use within 96 h of starting study treatment was associated with diminished differences in cure rates between treatments. CONCLUSIONS: Ceftaroline fosamil was superior to ceftriaxone for empirical treatment of adults hospitalized with CAP. Receipt of prior antimicrobial therapy appeared to diminish the observed treatment effect.
Identifier
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<a href="http://doi.org/10.1093/jac/dkv415" target="_blank" rel="noreferrer noopener">10.1093/jac/dkv415</a>
Rights
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2016
Anti-Bacterial Agents/*therapeutic use
Bacterial/*drug therapy
Ceftriaxone/*therapeutic use
Cephalosporins/*therapeutic use
Community-Acquired Infections/*drug therapy
Department of Internal Medicine
File Thomas M
Friedland H David
Humans
Iaconis Joseph P
Llorens Lily
Melnick David
NEOMED College of Medicine
Pneumonia
Randomized Controlled Trials as Topic
Sun Fang
Taboada Maria
The Journal of antimicrobial chemotherapy
Wilson David
Zhong Nan Shan