A Review: Effectiveness of Cephalosporins/Siderophore Cephalosporins versus Meropenem as Therapy in Patients with Hospital Acquired Pneumonia

Background: Hospital-Acquired Pneumonia (HAP) is a nosocomial infection that causes mortality and morbidity. It also leads to increased length of hospitalization and cost of care. Increasing antibiotic resistance necessitates the search for alternative antibiotics, such as HAP therapy. Carbapenem antibiotics as standard HAP antibiotics and cephalosporins/cephalosporin siderophores have proven effective for infections caused by gram-negative bacteria that cause HAP. This review aimed to evaluate the combination of cephalosporins and beta-lactamase inhibitors as an effective therapy for HAP that can reduce the risk of antibiotic resistance. Methods: Cochrane and PubMed were the sources for searching articles in this study. The articles were then selected by using the PICO method (Population, Intervention, Comparison, and Outcomes). The target population was adult HAP patients, with interventions of cefiderocol, ceftazidime-avibactam, and ceftolozane-tazobactam. The comparator in this study was meropenem, and the outcome was clinical improvement with microbiological response and mortality as the parameters. The PRISMA flow chart later described a summation of this review study. Results: Eight articles comprehensively discussed the effectiveness of cephalosporins/siderophore cephalosporins and meropenem against Klebsiella pneumonia, Pseudomonas aeruginosa, and Escherichia coli. The clinical recovery of patients after administering these two antibiotics showed high therapeutic effectiveness and could reduce mortality. Ceftazidime-avibactam, ceftolozane-tazobactam, and cefiderocol are new antibiotics that are effective for HAP. Meropenem at high doses can offset the efficacy of the three antibiotic combinations and minimize antibiotic resistance. Conclusion: Meropenem and cephalosporins/siderophore cephalosporins have similar effectiveness as therapy for gram-negative infections in HAP, with attention to dosage to obtain effective therapy. Keywords: Cephalosporins, Hospital Acquired Pneumonia, Meropenem, Nosocomial Pneumonia.