Abstract
BACKGROUND: Cefoperazone-sulbactam is a broad-spectrum antibiotic known for its activity against a wide range of pathogens, including multidrug-resistant organisms (MDROs). This systematic review and meta-analysis aim to compare the efficacy and safety of cefoperazone-sulbactam with other cephalosporins in the treatment of infections. METHODS: We conducted a comprehensive search of PubMed, Web of Science, Scopus, Cochrane Library, Medline, EMBASE, and CNKI databases for relevant studies up until July 11, 2024. Randomized controlled trials (RCTs) that compared cefoperazone-sulbactam with other cephalosporins in treating infections were included. Data were analyzed using RevMan 5.3 software, and the relative risk (RR) and mean difference (MD) were calculated. Sensitivity analysis and subgroup analyses were performed to ensure result robustness. RESULTS: Seven RCTs involving 1017 patients were included in the analysis. Cefoperazone-sulbactam demonstrated a significantly higher treatment success rate (RR = 1.08, 95% CI [1.02-1.13], P = .003) and superior microbial clearance rate (RR = 1.22, 95% CI [1.11-1.34]) compared to other cephalosporins. Sensitivity analyses confirmed the stability of these findings. Adverse reactions were similar between groups, with cefoperazone-sulbactam demonstrating good safety and tolerability. CONCLUSION: Cefoperazone-sulbactam shows superior efficacy compared to other cephalosporins in the treatment of infections, particularly in cases involving multidrug-resistant organisms. It also exhibits a comparable safety profile, making it a valuable option in clinical practice. However, further multicenter RCTs are needed to fully assess its potential in broader clinical applications.