Assessing Clinical Effectiveness of Ceftolozane/Tazobactam, Ceftazidime/Avibactam, and Meropenem/Vaborbactam in Bacteremia: A Systematic Review and Meta-Analysis
- Journal
- Antibiotics (Basel, Switzerland) (Q1)
- Published
- 31 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Shahd Mohammad, Mosab Albalas, Mohammad M Al-Ahmad
- PMID
- 42791993
- DOI
- 10.3390/antibiotics15090843
Why clinicians should know about it
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (top studies of the week, 27 September 2026): SR/MA of RCTs on BL/BLIs efficacy in bacteremia
Abstract
Background/Objectives: Bacteremia poses a significant clinical challenge, often necessitating the off-label use of novel β-lactam/β-lactamase inhibitor (BL/BLI) combinations such as Ceftolozane/Tazobactam (C/T), Ceftazidime/Avibactam (C/A), and Meropenem/Vaborbactam (M/V). Despite their widespread use, no conclusive data support their effectiveness in bacteremia. This meta-analysis aims to evaluate the clinical effectiveness of C/T, C/A, and M/V in treating bacteremia, with a focus on survival outcomes and clinical cure rates. Methods: A systematic review and meta-analysis were conducted following a comprehensive search of Scopus and PubMed databases. Studies reporting survival and clinical cure rates in patients treated with C/T, C/A, or M/V for bacteremia were included. Data extraction followed predefined criteria, and a random-effects meta-analysis was performed to synthesize the findings. Results: Twenty studies met the inclusion criteria, with 18 reporting survival outcomes and 10 evaluating clinical cure rates. The pooled survival and clinical cure rates were 73.6% (95% CI: 67.5-79.8%, p < 0.001) and 76.2% (95% CI: 69.2-83.3%, p < 0.001), respectively, both exhibiting moderate heterogeneity. Subgroup analyses revealed consistent survival trends across study quality, with low- and high-risk-of-bias studies demonstrating comparable estimates. Given that C/A was the most frequently studied agent, its dedicated subgroup analysis yielded a pooled survival estimate of 73.4% (95% CI: 66.4-80.3%, p < 0.001). Conclusions: This meta-analysis provides supporting evidence for the clinical effectiveness of C/T, C/A, and M/V in bacteremia reinforcing the role of BL/BLIs in antimicrobial stewardship as viable options for resistant infections. However, further randomized controlled trials (RCTs) are warranted to validate these results and refine treatment strategies for bacteremia.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.