Ceftolozane/Tazobactam Plus Metronidazole: Effective Treatment for Intra-Abdominal Infection

Key findings of the study:

• Escherichia coli was found in 78 patients, Klebsiella pneumonia in 22, and Pseudomonas aeruginosa in 5, making gram-negative aerobes the most frequently identified pathogens in patients who followed the study protocol.
• Clinical cure rates were 85.1% for group 1 and 89.6% for group 2 in the ITT population (difference, -4.4%; 95% CI, -12.6% to 3.7%).
• In comparison between groups 1 & 2, the clinical cure rates were 94.0% and 95.0% for gram-negative aerobes (difference, -1.0%; 95% CI, -11.9% to 8.7%), 93.8% and 95.7% for E coli (different, -1.9%; 95% CI, -16.5% to 9.4%), 100% and 9.1% for K pneumonia (difference, 9.1%; 95% CI, -19.0% to 38.5%), and 80.0% and 88.2% for gram-positive aerobes (difference, -8.2%; 95% CI, -42.2% to 20.0%), respectively.
• Subjects in groups 1 and 2 experienced similar rates of drug-related side effects, such as abdominal distension (1.5% vs 0%), abnormal liver function (0% vs 2.2%), diarrhea (1.5% vs 2.2%), nausea (1.5% vs 0.7%), peripheral edema (2.2% vs 1.5%), and rash (0.7% vs 1.5%).
• one death noted in Group 2 and none in group 1.

In China, "ceftolozane and tazobactam plus metronidazole may provide another alternative for antibacterial therapy of complicated intra-abdominal infection, potentially addressing the demand for treatment choices for multidrug-resistant infections," the researchers concluded.

REFERENCE

Sun Y, Fan J, Chen G, et al. A phase 3, multicenter, double-blind, randomized clinical trial to evaluate the efficacy and safety of ceftolozane/tazobactam plus metronidazole versus meropenem in chinese participants with complicated intra-abdominal infections. Int J Infect Dis. 2022;123:157-165. doi:10.1016/j.ijid.2022.08.003