Meta-analysis of the efficacy and safety of doripenem in the treatment of bacterial infections

The objective of the meta-analysis, published in the Brazilian Journal of Infectious Diseases, was to compare the efficacy and safety of doripenem with other antibiotics commonly used in the treatment of bacterial infections.

The meta-analysis included 6 randomized controlled clinical trials that were present in the PubMed and Embase databases (the research was conducted until July 31, 2014). The studies included in the meta-analysis have evaluated the efficacy and safety of doripenem in complicated intra-abdominal infections, complicated urinary tract infections, nosocomial pneumonia and acute biliary tract infections.

Compared to other empirically prescribed antimicrobials, the overall efficacy of doripenem treatment was comparable in the frequency of clinical and microbiological success of treatment (for the patient population to be assessed clinically, the odds ratio was 1.26, 95% confidence interval 0.93-1.69, p = 0.13; for the modified patient population subject to clinical evaluation (ITT), OR 0.88, 95% CI 0.55-1, 41, p = 0.6; for patient population subjected to microbiological evaluation, OR 1.16, 95% CI 0.9-1.5, p = 0.26; for modified pop population ENTOV microbiological evaluation (ITT), OR 0.98, 95% CI 0.81-1.2, p = 0.87).

By comparing the frequency of occurrence of adverse events and the fatal outcome for all reasons, it was found that doripenem is comparable to comparator drugs both in the frequency of development of adverse events and in the rate of mortality for all reasons, when analyzing a modified population of patients subjected to clinical evaluation (for the indicator, the frequency of AE 1.1, 95% CI 0.9-1.35, p = 0.33; for the all-cause mortality rate, OR 1.08, 95% CI 0.77-1.51, p = 0.67). With nosocomial pneumonia and ventilator-associated pneumonia, treatment with doripenem was comparable to other antibacterial drugs in terms of efficacy and safety according to the criterion of non-inferiority ("not worse").

Thus, according to the results of the meta-analysis, doripenem is an acceptable and well-tolerated option for the empirical antibacterial treatment of complicated intra-abdominal infections, complicated urinary tract infections, nosocomial pneumonia and acute biliary tract infections.