CRD Summary: The authors concluded that ertapenem was as effective and safe as other antimicrobials for complicated intra-abdominal infections; evidence was limited to patients with mild-to-moderate infections caused by one or more susceptible pathogens. Apart from the exclusion of two foreign-language studies, the review was generally well-conducted and the conclusions were likely to be reliable.

[Most of the included studies compared 1 g of ertapenem once daily (intravenous or intramuscular) with antipseudomonal penicillins/beta-lactamase inhibitor combinations (piperacillin/tazobactam or ticarcillin/clavulanic acid); other studies used ceftriaxone plus metronidazole as the comparator. ]

CRD Commentary: The review question was clearly stated and inclusion criteria were defined. Several relevant sources were searched, but no attempts were made to minimise publication bias. Publications in several languages were eligible, but two potentially relevant studies in non-eligible languages were excluded. Appropriate methods were used to minimise reviewer error and bias during the selection of studies and data extraction, but it was not stated if similar methods were used for the validity assessment. Only RCTs were included and validity was assessed, although only the aggregated score was reported. Appropriate methods were used for the meta-analyses, heterogeneity was assessed and various subgroup analyses conducted. Apart from the exclusion of two foreign-language studies, the review was generally well-conducted and the authors' conclusions were likely to be reliable.

All of the included studies were conducted by the manufacturer of ertapenem.