Determinants of inappropriate empirical antibiotic treatment: systematic review and meta-analysis

2018 ◽  
Vol 51 (4) ◽  
pp. 548-553 ◽  
Author(s):  
Elena Carrara ◽  
Iris Pfeffer ◽  
Oren Zusman ◽  
Leonard Leibovici ◽  
Mical Paul
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
Meta Analysis ◽  
Empirical Antibiotic Treatment

scholarly journals Systematic review and meta-analysis: susceptibility-guided versus empirical antibiotic treatment forHelicobacter pyloriinfection

2015 ◽  
Vol 70 (9) ◽  
pp. 2447-2455 ◽  
Author(s):  
Sheila López-Góngora ◽  
Ignasi Puig ◽  
Xavier Calvet ◽  
Albert Villoria ◽  
Mireia Baylina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
Meta Analysis ◽  
Empirical Antibiotic Treatment

scholarly journals Systematic Review and Meta-Analysis of the Efficacy of Appropriate Empiric Antibiotic Therapy for Sepsis

2010 ◽  
Vol 54 (11) ◽  
pp. 4851-4863 ◽  
Author(s):  
Mical Paul ◽  
Vered Shani ◽  
Eli Muchtar ◽  
Galia Kariv ◽  
Eyal Robenshtok ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Antibiotic Treatment ◽  
Effect Size ◽  
Observational Studies ◽  
Meta Analysis ◽  
Empiric Antibiotic Therapy ◽  
Clinical Variable ◽  
Empirical Antibiotic Treatment ◽  
All Cause Mortality

ABSTRACT Quantifying the benefit of early antibiotic treatment is crucial for decision making and can be assessed only in observational studies. We performed a systematic review of prospective studies reporting the effect of appropriate empirical antibiotic treatment on all-cause mortality among adult inpatients with sepsis. Two reviewers independently extracted data. Risk of bias was assessed using the Newcastle-Ottawa score. We calculated unadjusted odds ratios (ORs) with 95% confidence intervals for each study and extracted adjusted ORs, with variance, methods, and covariates being used for adjustment. ORs were pooled using random-effects meta-analysis. We examined the effects of methodological and clinical confounders on results through subgroup analysis or mixed-effect meta-regression. Seventy studies were included, of which 48 provided an adjusted OR for inappropriate empirical antibiotic treatment. Inappropriate empirical antibiotic treatment was associated with significantly higher mortality in the unadjusted and adjusted comparisons, with considerable heterogeneity occurring in both analyses (I 2 > 70%). Study design, time of mortality assessment, the reporting methods of the multivariable models, and the covariates used for adjustment were significantly associated with effect size. Septic shock was the only clinical variable significantly affecting results (it was associated with higher ORs). Studies adjusting for background conditions and sepsis severity reported a pooled adjusted OR of 1.60 (95% confidence interval = 1.37 to 1.86; 26 studies; number needed to treat to prevent one fatal outcome, 10 patients [95% confidence interval = 8 to 15]; I 2 = 46.3%) given 34% mortality with inappropriate empirical treatment. Appropriate empirical antibiotic treatment is associated with a significant reduction in all-cause mortality. However, the methods used in the observational studies significantly affect the effect size reported. Methods of observational studies assessing the effects of antibiotic treatment should be improved and standardized.

Assessment of the use of vitamin C and E supplements concomitantly to antibiotic treatment against Helicobacter pylori : A systematic review and meta-analysis

2018 ◽  
Vol 151 (2) ◽  
pp. 45-52
Author(s):  
Edgar Yaset Caicedo Ochoa ◽  
César Orlando Quintero Moreno ◽  
Yardany Rafael Méndez Fandiño ◽  
Sofía Catalina Sánchez Fonseca ◽  
Héctor Fabio Cortes Motta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Vitamin C ◽  
Antibiotic Treatment ◽  
Meta Analysis

scholarly journals Antibiotic treatment for ocular toxoplasmosis: a systematic review and meta-analysis: study protocol

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
John E. Feliciano-Alfonso ◽  
Andrés Vargas-Villanueva ◽  
María Alejandra Marín ◽  
Laura Triviño ◽  
Natalia Carvajal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
Study Protocol ◽  
Meta Analysis ◽  
Ocular Toxoplasmosis ◽  
Analysis Study

scholarly journals Effects of Antibiotic Therapy in Primary Sclerosing Cholangitis with and without Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 39 (04) ◽  
pp. 432-441 ◽  
Author(s):  
Ayesha Shah ◽  
Darrel Crawford ◽  
Daniel Burger ◽  
Neal Martin ◽  
Marjorie Walker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Therapy ◽  
Primary Sclerosing Cholangitis ◽  
Antibiotic Treatment ◽  
Sclerosing Cholangitis ◽  
Serum Alkaline Phosphatase ◽  
Meta Analysis ◽  
Total Serum ◽  
Inflammatory Bowel ◽  
Positive Effect

AbstractThe authors conducted a systematic review and meta-analysis to assess the effect of antibiotic therapy in primary sclerosing cholangitis (PSC). Effect of antibiotic therapy on Mayo PSC Risk Score (MRS), serum alkaline phosphatase (ALP), total serum bilirubin (TSB), and adverse events (AEs) rates were calculated and expressed as standardized difference of means or proportions. Five studies including 124 PSC patients who received antibiotics were included. Overall, antibiotic treatment was associated with a statistically significant reduction in ALP, MRS, and TSB by 33.2, 36.1, and 28.8%, respectively. ALP reduction was greatest for vancomycin (65.6%, p < 0.002) and smallest with metronidazole (22.7%, p = 0.18). Overall, 8.9% (95% confidence interval: 3.9–13.9) of patients had AEs severe enough to discontinue antibiotic therapy. In PSC patients, antibiotic treatment results in a significant improvement in markers of cholestasis and MRS. Antibiotics, particularly vancomycin, may have a positive effect on PSC either via direct effects on the microbiome or via host-mediated mechanisms.

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