Table_4_Effectiveness of ertapenem for treatment of infections in children: An evidence mapping and meta-analysis.DOCX

ObjectivesTo assess and summarize current evidence on the effectiveness and safety of ertapenem for treatment of childhood infections, in consideration of high infection prevalence in children and wide use of ertapenem.MethodsThe following 8 databases were searched on 13th May 2021: Web of Science, Embase via Ovid SP, PubMed, The Cochrane Library (CENTRAL), Chinese BioMedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP and Wanfang. The primary outcome was treatment success rate. Risk ratios (RRs) and 95% confidence interval (CI) were estimated using random-effect models. Subgroup analysis was conducted where heterogeneity was found.ResultsFifteen studies (8 randomized controlled trials, 1 observational comparative study, and 6 before and after studies) involving 2,528 patients were included in the final review. Ertapenem had similar treatment success rates with β-lactam antibiotics [relative risk (RR) = 1.08, 95% CI: 0.99–1.19]. In a subgroup analysis, similar efficacy (RR = 1.08, 95% CI: 0.97–1.20) between ertapenem and other carbapenems. Compared with β-lactam antibiotics, ertapenem did not increase the risk of any adverse events (RR = 1.02, 95%CI: 0.71–1.48), drug-related diarrhea (all non-Asian children, RR = 0.62, 95%CI: 0.31–1.25), or injection site pain (all non-Asian children, RR = 1.66, 95%CI: 0.59–4.68). Subgroup analysis showed no obvious difference between ertapenem group and carbapenems or non-carbapenems group on risk of adverse events.ConclusionOur findings suggest that ertapenem is effective and safe in treatment for children with infection. Further comparative real-world data is needed to supplement clinical evidence on the overall benefits of ertapenem in this population.

旨在评估和总结关于厄他培南治疗儿童感染的有效性和安全性的现有证据，鉴于儿童感染的高发病率以及厄他培南的广泛使用。方法：于2021年5月13日检索了以下8个数据库：Web of Science、Embase via Ovid SP、PubMed、Cochrane图书馆（CENTRAL）、中国生物医学文献数据库（CBM）、中国国家级知识基础设施（CNKI）、VIP和万方。主要结局指标为治疗成功率。采用随机效应模型估计风险比（RR）和95%置信区间（CI）。在存在异质性的情况下进行了亚组分析。结果：最终审查纳入了15项研究（8项随机对照试验、1项观察性比较研究和6项前后对照研究），涉及2,528名患者。厄他培南的治疗成功率与β-内酰胺类抗生素相似[相对风险（RR）= 1.08，95% CI: 0.99–1.19]。在亚组分析中，厄他培南与其他碳青霉烯类抗生素的疗效相似（RR = 1.08，95% CI: 0.97–1.20）。与β-内酰胺类抗生素相比，厄他培南并未增加任何不良事件的风险（RR = 1.02，95% CI: 0.71–1.48）、药物相关性腹泻（所有非亚洲儿童，RR = 0.62，95% CI: 0.31–1.25）或注射部位疼痛（所有非亚洲儿童，RR = 1.66，95% CI: 0.59–4.68）。亚组分析显示，在不良事件风险方面，厄他培南组与碳青霉烯类或非碳青霉烯类药物组之间无显著差异。结论：我们的研究结果提示，厄他培南在治疗儿童感染方面具有有效性和安全性。需要进一步的临床真实世界比较数据，以补充关于该人群中使用厄他培南总体益处的临床证据。