This study aims to assess the clinical e_cacy and safety of eravacycline for treating\ncomplicated intra-abdominal infection (cIAI) in adult patients. The PubMed, Web of Science, EBSCO,\nCochrane databases, Ovid Medline, Embase, and ClinicalTrials.gov were searched up to May 2019.\nOnly randomized controlled trials (RCTs) that evaluated eravacycline and other comparators for the\ntreatment of cIAI were included. The primary outcome was the clinical cure rate at the test-of-cure\nvisit based on modified intent-to-treat population, microbiological intent-to-treat population, clinically\nevaluable population, and microbiological evaluable population, and the secondary outcomes were\nclinical failure rate and the risk of adverse event. Three RCTs were included. Overall, eravacycline\nhad a clinical cure rate (88.7%, 559/630) at test-of-cure in modified intent-to-treat population similar\nto comparators (90.1%, 492/546) in the treatment of cIAIs (risk ratio (RR), 0.99; 95% confidence\ninterval (CI), 0.95-1.03; I^2 = 0%, Figure 3). In the microbiological intent-to-treat, clinically evaluable,\nand microbiological evaluable populations, no difference was found between eravacycline and\ncomparators in terms of clinical cure rate at test-of-cure (microbiological intent-to-treat population,\nRR, 0.99; 95% CI, 0.95-1.04; I^2 = 0%, clinically evaluable population, RR, 1.00; 95% CI, 0.97-1.03; I^2 = 0%,\nmicrobiological evaluable population, RR, 0.98; 95% CI, 0.95-1.02; I^2 = 0%). In addition, eravacycline\nhad clinical failure rate similar to comparators at test-of-cure in modified intent-to-treat population (RR,\n1.01; 95% CI, 0.61-0.69; I^2 = 0%), microbiological intent-to-treat population (RR, 1.34; 95% CI, 0.77-2.31;\nI^2 = 16%), clinically evaluable population (RR, 1.03; 95% CI, 0.61-1.76; I^2 = 0%), and microbiological\nevaluable population (RR, 1.32; 95% CI, 0.75-2.32; I^2 = 10%). Although eravacycline was associated\nwith higher risk of treatment-emergent adverse event than comparators (RR, 1.34; 95% CI, 1.13-1.58;\nI^2 = 0%), no significant differences were found between eravacycline and comparators for the risk of\nserious adverse event (RR, 1.04; 95% CI, 0.65-1.65; I^2 = 0%), discontinuation of study drug because\nof adverse event (RR, 0.68; 95% CI, 0.23-1.99; I^2 = 13%), and all-cause mortality (RR, 1.09; 95%\nCI, 0.41-2.9; I^2 = 28%). In conclusion, the clinical efficacy of eravacycline is as high as that of the\ncomparator drugs in the treatment of cIAIs and this antibiotic is as well tolerated as the comparators.
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