Efficacy and aafety of plazomicin in complicated UTI and pyelonephritis: A meta-analysis of randomized controlled trials

Background: Plazomicin is a derivative of sisomicin and a next-generation aminoglycoside currently under clinical development for the treatment of gram-negative bacterial infections. Objective: To determine the effect of plazomicin as a treatment for Enterobacteria infections in hospitalized patients. Materials and Methods: Studies were selected from PubMed, Scopus, Cochrane, and Google Scholar. Data were collected and recorded using the Cochrane collaboration's Revman 5.0 program. Results: Two randomized controlled trials (RCTs) were included, with a total of 468 patients, with a mean age of 51.5 years and a predominance of female participants (68.5%). The clinical outcome in the two RCTs demonstrated that clinical recovery in the plazomicin group was similar to the control group (OR, 0.86; 95% CI, 0.49-1.51; I2 = 0%). Microbiological eradication of Enterobacteria in the plazomicin group was similar to the control group (OR, 1.15; 95% CI, 0.52-2.53; I2 = 0%). The incidence of adverse events in the plazomicin group was similar to the control group (OR, 0.81; 95% CI, 0.57-1.15; I2 = 0%). Conclusion: In this meta-analysis, plazomicin demonstrated similar effects on clinical outcomes, microbiological eradication, and adverse events compared to the control groups. Therefore, plazomicin did not show significant differences when compared to control groups in patients infected with Enterobacteria. More randomized controlled trials are needed to provide better clinical evidence in patients with Enterobacteria infections resistant to aminoglycosides.