Efficacy of Ceftriaxone 1 g daily Versus 2 g daily for The Treatment of Community-Acquired Pneumonia: A Systematic Review with Meta-Analysis.

Abstract

Introduction: Ceftriaxone has been recommended as a first-line treatment for various infections; however, the doses for pneumonia have not been a consensus in randomized clinical trials. To compare ceftriaxone 1 g daily efficacy to other ceftriaxone dosing regimens in community-acquired pneumonia. Area covered: We performed a systematic review and meta-analysis on PubMed, Web of Science, Scopus, and LILACS. Randomized controlled trials of ceftriaxone in community-acquired pneumonia were included. Outcomes included clinical cure in modified intention-to-treatment, clinically and microbiologically evaluable patients. Expert opinion: Ceftriaxone dosages of 1 g daily are as safe and effective as other antibiotic regimens for community-acquired pneumonia. Twenty-four articles fulfilled the inclusion criteria. Twelve studies evaluated ceftriaxone regimens at a dosage of 2 g daily and 12 studies evaluated ceftriaxone at a dosage of 1 g daily. The odds-ratio of clinical cure in the modified intention-to-treatment patients administered either ceftriaxone (4666 patients) or a comparator (4411 patients) was 0.98 (95% CI [0.82-1.17]). Comparator regimens showed similar efficacy to ceftriaxone regimens of 1 g daily, with an odds ratio of 1.03 (95% CI [0.88-1.20]). Dosages higher than ceftriaxone 1 g daily did not result in improved clinical outcomes for community-acquired pneumonia patients (OR 1.02, 95% CI [0.91-1.14]).

• Authors: João Paulo Telles, Juliette Cieslinski, Juliano Gasparetto, Felipe Francisco Tuon
• Journal: Expert review of anti-infective therapy (Expert Rev Anti Infect Ther) Vol. 17 Issue 7 Pg. 501-510 (07 2019) ISSN: 1744-8336 [Electronic] England
• PMID: 31179786 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Anti-Bacterial Agents
• Ceftriaxone

Topics

• Anti-Bacterial Agents (administration & dosage, adverse effects)
• Ceftriaxone (administration & dosage, adverse effects)
• Community-Acquired Infections (drug therapy)
• Dose-Response Relationship, Drug
• Humans
• Pneumonia (drug therapy)
• Randomized Controlled Trials as Topic
• Treatment Outcome