Doripenem versus meropenem as first-line empiric therapy of febrile neutropenia in patients with acute leukemia: a prospective, randomized study

Oyake, Tatsuo; Takemasa-Fujisawa, Yuka; Sugawara, Norifumi; Mine, Takahiko; Tsukushi, Yasuhiko; Hanamura, Ichiro; Fujishima, Yukiteru; Aoki, Yusei; Kowata, Shugo; Ito, Shigeki; Ishida, Yoshiteru

doi:10.1007/s00277-019-03634-w

Cited by 1 publication

(11 citation statements)

References 16 publications

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“…Finally, a total of eight RCTs [7,8,10,11,12,13,14,15] fulfilling the inclusion criteria were included in this meta-analysis (Figure 1). All of studies were designed to compare the clinical efficacy and safety of doripenem with other antibiotics for patients with acute bacterial infection (Table 1) [7,8,10,11,12,13,14,15]. During the initial enrollment, doripenem and comparators were applied to 1736 and 1763 patients, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies focused on complicated urinary tract infections (cUTI) [7,13] and intra-abdominal infections (IAI) [14,15]. Only one study investigated febrile neutropenia [8]. Five studies [8,11,12,14,15] compared doripenem with other carbapenems including imipenem in three studies [11,12,14] and meropenem in two studies [8,15].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies [8,11,12,14,15] compared doripenem with other carbapenems including imipenem in three studies [11,12,14] and meropenem in two studies [8,15]. The regimen of doripenem was 1 g every eight hours in two studies [8,11] and 500 mg every eight hours in the other six studies [7,10,12,13,14,15]. For the two studies using double dose of doripenem (1 g every eight hour), the study drug (doripenem or meropenem) was used for at least five days in one study [8] and another one [11] compared seven-day doripenem versus 10-day imipenem-cilastatin.…”

Section: Resultsmentioning

confidence: 99%

“…Although Qu et al [6] conducted a meta-analysis of doripenem for treating bacterial infections in 2015, only six clinical trials were enrolled and the number of patients was limited. Since then, two more studies investigating the efficacy of doripenem in comparison with other comparators were reported [7,8]. In Wagenlehner et al’s study [7], 1033 randomized patients were enrolled, and they did the comparison between doripenem and ceftazidime-avibactam for the treatment of cUTI.…”

Section: Introductionmentioning

confidence: 99%

“…In Wagenlehner et al’s study [7], 1033 randomized patients were enrolled, and they did the comparison between doripenem and ceftazidime-avibactam for the treatment of cUTI. In Oyake et al’s study [8], they compared the empirical use of doripenem versus meropenem for febrile neutropenia in patients with acute leukemia. These two studies provided more patients and different types of infections compared to previse meta-analysis [6].…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy and Safety of Doripenem in the Treatment of Acute Bacterial Infections—A Systemic Review and Meta-Analysis of Randomized Controlled Trials

Lai

Cheng

Chen

et al. 2019

JCM

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This study aims to assess the efficacy and safety of doripenem on treating patients with acute bacterial infections. The Pubmed, Embase, and Cochrane databases were searched up to April 2019. Only randomized clinical trials comparing doripenem and other comparators for the treatment of acute bacterial infection were included. The primary outcome was the clinical success rate and the secondary outcomes were microbiological eradication rate and risk of adverse events. Eight randomized controlled trials (RCTs) were included. Overall, doripenem had a similar clinical success rate with comparators (odds ratio [OR], 1.15; 95% CI, 0.79–1.66, I2 = 58%). Similar clinical success rates were noted between doripenem and comparators for pneumonia (OR, 0.84; 95% CI, 0.46–1.53, I2 = 72%) and for intra-abdominal infections (OR, 1.00; 95% CI, 0.57–1.72). For complicated urinary tract infection, doripenem was associated with higher success rate than comparators (OR, 1.89, 95% CI, 1.13–3.17, I2 = 0%). The pool analysis comparing doripenem and other carbapenems showed no significant differences between each other (OR, 0.96, 95% CI, 0.59–1.58, I2 = 63%). Doripenem also had a similar microbiological eradication rate with comparators (OR, 1.08; 95% CI, 0.86–1.36, I2 = 0%). Finally, doripenem had a similar risk of treatment-emergent adverse events as comparators (OR, 0.98; 95% CI, 0.83–1.17, I2 = 33%). In conclusion, the clinical efficacy of doripenem is as high as that of the comparator drugs in the treatment of acute bacterial infection; furthermore, this antibiotic is as well tolerated as the comparators.

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