Efficacy and safety of ceftazidime-avibactam in the treatment of complicated intra-abdominal infections (CIAIs) and complicated urinary tract infections (CUTIs): A meta-analysis of randomized controlled trials

Summary Objective: The aim of this study was to assess the efficacy and safety of ceftazidime-avibactam in the treatment of complicated intra-abdominal infections (CIAIs) and complicated urinary tract infections (CUTIs) with meta-analysis method. Method: We included six randomized clinical trials identified from Medline, Embase, Cochrane Library, "ISRCTN Register" and "ClinicalTrials.gov" which compared ceftazidime-avibactam with comparison group. The meta-analysis was performed using Review Manager software version 5.3. Results: Ceftazidime-avibactam versus active comparisons demonstrated a statistically significant higher rate of microbiological response success on microbiological evaluable populations at the test-of-cure visit (95CI 1.10-2.38, p=0.02) and late-follow-up visit (95CI 1.09-2.23, p=0.02) for the treatment of CUTIs. Ceftazidime-avibactam versus active comparisons demonstrated a statistically significant higher rate of microbiological response success on EME populations at the test-of-cure visit (95CI 1.08-4.27, p=0.03) and late-follow-up visit (OR=1.75, 95CI 1.33-2.29, p<0.0001) for the treatment of CUTIs. Similar results were obtained at the late-follow-up visit (OR = 1.58, 95CI 1.26-1.97, p<0.0001) on microbiologically modified intent-to-treat (mMITT) populations for the treatment of CUTIs. We can find better eradication rates for E. coli and Klebsiella pneumoniae based on mMITT populations. In terms of AEs, SAEs and mortality, ceftazidime-avibactam had a safety and tolerability profile broadly similar to the comparison group. Conclusion: This meta-analysis provides evidence of the efficacy of ceftazidime-avibactam as a potential alternative for the treatment of patients with CUTIs, and CIAIs.

Efficacy and impact of premedication with eszopiclone on sleep structure of patients with acute insomnia / 中华神经科杂志

Objective To evaluate the efficacy of eszopiclone for patients with acute insomnia and the impact of premedication with eszopiclone on sleep structure of patients with acute insomnia.Methods In an open-label,self-control trial was conducted at Changzheng Hospital Sleep Centers,and patients (n =32) with acute insomnia (12 men,20 women; mean age,36.2 years) were administered eszopiclone 3 mg for three consecutive nights.Sleep was monitored via polysomnography.The insomnia severity index (ISI),and mini-mental state examination (MMSE) were used to assess the degree of insomnia and impact of drugs on cognitive function during the day.Results Eszopiclone can shorten sleep latency ( before treatment:(52.92 ± 11.71 ) min,after treatment:(28.2 ± 10.11 ) min; t =-4.376,P ＜0.01 ),prolong total sleep time(before treatment:(365.22 ±30.13) min,after treatment:(429.18 ±26.93 ) min; t =4.102,P ＜ 0.01 ),decrease wake up times( before treatment:( 5.00 ± 1.92 ) times,after treatment:( 2.73 ± 0.91 )times; t =- 4.592,P ＜ 0.01 ),improve sleep efficiency ( before treatment:72.69％ ± 6.32％,after treatment:82.67％ ± 4.16％ ; t =3.371,P ＜ 0.01 ),reduce awake time ( before treatment:( 88.51 ±17.48) min,after treatment:(65.93 ±21.l0)min; t =-4.592,P ＜0.01 ),decrease light sleep ( NREM1 period) the percentage of time ( before treatment:12.54％ ± 2.10％,after treatment:7.30％ ± 2.90％ ;t=-3.155,P ＜ 0.01 ),and increase the percentage of slow wave sleep (before treatment:8.03％ ±5.37％,after treatment:9.31％ ±5.29％; t =4.228,P ＜0.01).No effect was observed on the percentage of NERM2 period (t =0.731,P ＞0.05) and REM period (t =-0.813,P ＞0.05).Eszopiclone can improve the quality of subjective assessment of sleep ( ISI score decreased,t =- 2.551,P ＜ 0.05) and has no significant effect on cognitive function on first the morning after patients taking the medication.Conclusion Eszopiclone can positively regulate the sleep structure in patients with acute insomnia and improve subjective assessment of sleep quality.It is safe and has no significant effect on cognitive function.