Antibiotics Prescribing in Intensive Care Settings during the COVID-19 Era: A Systematic Review

The prevalence of patients admitted to intensive care units (ICUs) with SARS-CoV-2 infection who were prescribed antibiotics is undetermined and might contribute to the increased global antibiotic resistance. This systematic review evaluates the prevalence of antibiotic prescribing in patients admitted to ICUs with SARS-CoV-2 infection using PRISMA guidelines. We searched and scrutinized results from PubMed and ScienceDirect databases for published literature restricted to the English language up to 11 May 2021. In addition, we included observational studies of humans with laboratory-confirmed SARS-CoV-2 infection, clinical characteristics, and antibiotics prescribed for ICU patients with SARS-CoV-2 infections. A total of 361 studies were identified, but only 38 were included in the final analysis. Antibiotic prescribing data were available from 2715 patients, of which prevalence of 71% was reported in old age patients with a mean age of 62.7 years. From the reported studies, third generation cephalosporin had the highest frequency amongst reviewed studies (36.8%) followed by azithromycin (34.2%). The estimated bacterial infection in 12 reported studies was 30.8% produced by 15 different bacterial species, and S. aureus recorded the highest bacterial infection (75%). The fundamental outcomes were the prevalence of ICU COVID-19 patients prescribed antibiotics stratified by age, type of antibiotics prescribed, and the presence of co-infections and comorbidities. In conclusion, more than half of ICU patients with SARS-CoV-2 infection received antibiotics, and prescribing is significantly higher than the estimated frequency of identified bacterial co-infection.

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Free Tissue Transfer in Pressure Ulcer Reconstruction: A Systematic Review

Journal of Reconstructive Microsurgery Open ◽

10.1055/s-0041-1729640 ◽

2021 ◽

Vol 06 (01) ◽

pp. e35-e39

Author(s):

Chelsi Robertson ◽

Charles Patterson ◽

Hugo St. Hilaire ◽

Frank H. Lau

Keyword(s):

Systematic Review ◽

English Language ◽

Free Tissue Transfer ◽

Free Flaps ◽

Final Analysis ◽

The United States ◽

Local Flap ◽

Recurrence Rates ◽

Tissue Transfer ◽

Cochrane Database

Abstract Background Pressure ulcers (PUs) affect 2.5 million people in the United States annually and incur health-care costs of 11 billion dollars annually. Stage III/IV PU often require local flap reconstruction. Unfortunately, PU recurrence is common following reconstruction; recurrence rates as high as 82% have been reported. When local flap options are inadequate, free tissue transfer may be indicated but the indications have yet to be delineated. To develop evidence-based guidelines for the use of free flaps in PU reconstruction, we performed a systematic review. Methods A systematic review of the available English-language, peer-reviewed literature was conducted using PubMed/MEDLINE, Google Scholar, Scopus, EMBASE, and the Cochrane Database of Systematic Reviews. Articles were manually reviewed for relevance. Results Out of 272 articles identified, 10 articles were included in the final analysis. Overall, this systematic review suggests that free-flap PU reconstruction yields fewer recurrences compared with local flaps (0–20 vs. 13–82%). Further, several types of free flaps for PU reconstruction were identified in this review, along with their indications. Conclusion Free tissue transfer should be considered for recurrent PU. We offer specific recommendations for their use in PU reconstruction.

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Effect of revascularization on cognitive outcomes in intracranial steno-occlusive disease: a systematic review

Neurosurgical FOCUS ◽

10.3171/2018.11.focus18517 ◽

2019 ◽

Vol 46 (2) ◽

pp. E14 ◽

Cited By ~ 1

Author(s):

Bradley Kolb ◽

Hassan Fadel ◽

Gary Rajah ◽

Hamidreza Saber ◽

Ali Luqman ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Decline ◽

Cognitive Performance ◽

Observational Studies ◽

English Language ◽

Randomized Trials ◽

Occlusive Disease ◽

Cognitive Outcomes ◽

Thomson Reuters ◽

Before And After

OBJECTIVESteno-occlusive diseases of the cerebral vasculature have been associated with cognitive decline. The authors performed a systematic review of the existing literature on intracranial steno-occlusive disease, including intracranial atherosclerosis and moyamoya disease (MMD), to determine the extent and quality of evidence for the effect of revascularization on cognitive performance.METHODSA systematic search of PubMed/MEDLINE, the Thomson Reuters Web of Science Core Collection, and the KCI Korean Journal Database was performed to identify randomized controlled trials (RCTs) in the English-language literature and observational studies that compared cognitive outcomes before and after revascularization in patients with steno-occlusive disease of the intracranial vasculature, from which data were extracted and analyzed.RESULTSNine papers were included, consisting of 2 RCTs and 7 observational cohort studies. Results from 2 randomized trials including 142 patients with symptomatic intracranial atherosclerotic steno-occlusion found no additional benefit to revascularization when added to maximal medical therapy. The certainty in the results of these trials was limited by concerns for bias and indirectness. Results from 7 observational trials including 282 patients found some cognitive benefit for revascularization for symptomatic atherosclerotic steno-occlusion and for steno-occlusion related to MMD in children. The certainty of these conclusions was low to very low, due to both inherent limitations in observational studies for inferring causality and concerns for added risk of bias and indirectness in some studies.CONCLUSIONSThe effects of revascularization on cognitive performance in intracranial steno-occlusive disease remain uncertain due to limitations in existing studies. More well-designed randomized trials and observational studies are needed to determine if revascularization can arrest or reverse cognitive decline in these patients.

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Sleep Duration in Relation to Cognitive Function among Older Adults: A Systematic Review of Observational Studies

Neuroepidemiology ◽

10.1159/000442418 ◽

2016 ◽

Vol 46 (1) ◽

pp. 57-78 ◽

Cited By ~ 24

Author(s):

Elizabeth E. Devore ◽

Francine Grodstein ◽

Eva S. Schernhammer

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Function ◽

Sleep Duration ◽

Observational Studies ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Short Sleep ◽

Sleep Parameters

Context: Increasing evidence suggests that circadian and sleep parameters influence cognitive function with aging. Objective: To evaluate observational studies of sleep duration and cognition in older adults. Data Sources: A systematic review of OVID Medline and PsycINFO through September 2015, and review of bibliographies from studies identified. Study Selection: English-language articles reporting observational studies of sleep duration and cognitive function in older populations. Data Extraction: Data extraction by 2 authors using predefined categories of desired information. Results: Thirty-two studies met our inclusion criteria, with nearly two-thirds published in the past 4 years. One-third of studies indicated that extreme sleep durations were associated with worse cognition in older adults. More studies favored an association with long vs. short sleep durations (35 vs. 26% of studies, respectively). Four studies found that greater changes in sleep duration over time were related to lower cognition. Study design and analytic methods were very heterogeneous across studies; therefore, meta-analysis was not undertaken. Limitations: We reviewed English-language manuscripts only, with a qualitative summary of studies identified. Conclusions and Implications of Key Findings: Observational studies of sleep duration and cognitive function in older adults have produced mixed results, with more studies suggesting that long (rather than short) sleep durations are related to worse cognition. Studies more consistently indicate that greater changes in sleep duration are associated with poor cognition. Future studies should be prospectively designed, with objective sleep assessment and longer follow-up periods; intervention studies are also needed to identify strategies for promoting cognitive health with aging.

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Workplace neighbourhood built environment and workers’ physically-active and sedentary behaviour: a systematic review of observational studies

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-020-01055-x ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Chien-Yu Lin ◽

Mohammad Javad Koohsari ◽

Yung Liao ◽

Kaori Ishii ◽

Ai Shibata ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Built Environment ◽

Sedentary Behaviour ◽

Observational Studies ◽

English Language ◽

Research Priorities ◽

Working Hours ◽

Recreational Physical Activity ◽

Domain Specific

Abstract Background Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers’ physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies. Methods Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers’ physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019. Results A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving). Conclusions The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships. Protocol registration The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341).

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A Systematic Review of Screening Tests for Chronic Kidney Disease: An Accuracy Analysis

Galen Medical Journal ◽

10.31661/gmj.v9i0.1573 ◽

2020 ◽

Vol 9 ◽

pp. 1573

Author(s):

Fatemeh Keshvari-Shad ◽

Sakineh Hajebrahimi ◽

Maria Pilar Laguna Pes ◽

Alireza Mahboub-Ahari ◽

Mohammad Nouri ◽

...

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

English Language ◽

Scale Up ◽

Final Analysis ◽

Screening Tests ◽

Cochrane Library ◽

Screening Methods ◽

Dipstick Test

This systematic review was conducted to assess the diagnostic accuracy of chronic kidney disease screening tests in the general population. MEDLINE, EMBASE, Web of Science, Scopus, The Cochrane Library and ProQuest databases were searched for English-language publications up to November 2016. Two reviewers independently screened studies and extracted study data in standardized tables. Methodological quality was assessed using the QUADAS-2 tool. Sensitivity and specificity of all available screening methods were identified through included studies. Ten out of 1349 screened records included for final analysis. Sensitivities of the dipstick test with a cutoff value of trace were ranged from 37.1% to 69.4% and specificities from 93.7% to 97.3% for the detection of ACR>30 mg/g. The diagnostic sensitivities of the UAC>10 mg/dL testing was shown to vary from 40% to 87%, and specificities ranged from 75% to 96%. While the sensitivities of ACR were fluctuating between 74% and 90%, likewise the specificities were between 77% and 88%. Sensitivities for C-G, Grubb and Larsson equations were 98.9%, 86.2%, and 70.1% respectively. In the meantime the study showed specificities of 84.8%, 84.2% and 90.5% respectively for these equations. Individual studies were highly heterogeneous in terms of target populations, type of screening tests, thresholds used to detect CKD and variations in design. Results pointed to the superiority of UAC and dipstick over the other tests in terms of all parameters involved. The diversity of methods and thresholds for detection of CKD, necessitate considering the cost parameter along with the effectiveness of tests to scale-up an efficient strategy. [GMJ.2020;9:e1573]

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Meningoencephalitis associated with COVID-19: A systematic review

10.1101/2020.06.25.20140145 ◽

2020 ◽

Author(s):

Ritwick Mondal ◽

Upasana Ganguly ◽

Shramana Deb ◽

Gourav Shome ◽

Subhasish Pramanik ◽

...

Keyword(s):

Systematic Review ◽

English Language ◽

Final Analysis ◽

Systemic Review ◽

Cochrane Library ◽

Neurological Involvement ◽

P Value ◽

Neurological Manifestations ◽

Medical Subject Headings ◽

Laboratory Findings

AbstractBackground and aimsWith the growing number of COVID-19 cases in recent times, the varied range of presentations is progressively becoming an addressing issue among clinicians. A significant set of patients with extra pulmonary symptoms has been reported worldwide. Neurological involvement in the form of altered mental status, loss of consciousness in considerable amounts has drawn attention of physicians all across the globe. Here we venture out to summarise the clinical profile, investigations and radiological findings among patients with SARS-CoV-2 associated meningoencephalitis in the form of a systematic review, which may aid clinicians in early diagnosis and prognostic evaluation of the disease.MethodologyThis review was carried out based on the existing PRISMA (Preferred Report for Systemic Review and Meta analyses) consensus statement. The data for this review was collected from four databases: Pubmed/Medline, NIH Litcovid, Embase and Cochrane library and Preprint servers up till 10th June, 2020. Search strategy comprised of a range of keywords from relevant medical subject headings which includes “SARS-COV-2”, “COVID-19”, “meningoencephalitis” etc. All peer reviewed, case control, case report, pre print articles satisfying our inclusion criteria were involved in the study. The inclusion prerequisites comprised of confirmed SARS-CoV-2 cases with neurological manifestations, previous cases of SARS-CoV, MERS-CoV with neurological involvement provided all the studies were published in English language. Quantitative data was expressed in mean+/-SD, while the qualitative date in percentages. Paired t test was used for analysing the data based on differences between mean and respective values with a p value of <0.05 considered to be statistically significant.ResultsA total of 43 cases were involved from 24 studies after screening from databases and preprint servers, out of which 29 of them had completed investigation profile and were included in the final analysis. Clincial and Laboratory findings as well as neuroimaging findings (CT, MRI and MRS) revealed consistent presentations towards association of COVID-19 with meningoencephalitis. Epileptogenic pictures were also evident on EEG (electroencephalogram) findings.ConclusionSARS-CoV-2 has been isolated from CSF as well as cerebrum of cases with meningoencephalitis depicting the natural tendency of the virus to invade the central nervous system. Speculations about retrograde olfactory transport or alternative haematogenous spread seem to be correlating with above findings. This review may raise the index of suspicion about COVID-19 among clinicians while attending patients with neurological manifestations.

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Effect of famotidine on hospitalized patients with COVID-19: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0259514 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259514

Author(s):

Leonard Chiu ◽

Max Shen ◽

Chun-Han Lo ◽

Nicholas Chiu ◽

Austin Chen ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Observational Studies ◽

Meta Analysis ◽

Hospitalized Patients ◽

H2 Receptor Antagonist ◽

Histamine H2 Receptor ◽

Risk Of Death ◽

Care Services ◽

Potential Efficacy

Introduction Famotidine is a competitive histamine H2-receptor antagonist most commonly used for gastric acid suppression but thought to have potential efficacy in treating patients with Coronavirus disease 2019 (COVID-19). The aims of this systematic review and meta-analysis are to summarize the current literature and report clinical outcomes on the use of famotidine for treatment of hospitalized patients with COVID-19. Methods Five databases were searched through February 12, 2021 to identify observational studies that reported on associations of famotidine use with outcomes in COVID-19. Meta-analysis was conducted for composite primary clinical outcome (e.g. rate of death, intubation, or intensive care unit admissions) and death separately, where either aggregate odds ratio (OR) or hazard ratio (HR) was calculated. Results Four studies, reporting on 46,435 total patients and 3,110 patients treated with famotidine, were included in this meta-analysis. There was no significant association between famotidine use and composite outcomes in patients with COVID-19: HR 0.63 (95% CI: 0.35, 1.16). Across the three studies that reported mortality separated from other endpoints, there was no association between famotidine use during hospitalization and risk of death—HR 0.67 (95% CI: 0.26, 1.73) and OR 0.79 (95% CI: 0.19, 3.34). Heterogeneity ranged from 83.69% to 88.07%. Conclusion Based on the existing observational studies, famotidine use is not associated with a reduced risk of mortality or combined outcome of mortality, intubation, and/or intensive care services in hospitalized individuals with COVID-19, though heterogeneity was high, and point estimates suggested a possible protective effect for the composite outcome that may not have been observed due to lack of power. Further randomized controlled trials (RCTs) may help determine the efficacy and safety of famotidine as a treatment for COVID-19 patients in various care settings of the disease.

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Clinical Vignettes Provide an Understanding of Antibiotic Prescribing Practices in Neonatal Intensive Care Units

Infection Control and Hospital Epidemiology ◽

10.1086/660102 ◽

2011 ◽

Vol 32 (6) ◽

pp. 597-602 ◽

Cited By ~ 16

Author(s):

Sameer Patel ◽

Timothy Landers ◽

Elaine Larson ◽

Theoklis Zaoutis ◽

Patricia Delamora ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Prophylactic Antibiotic ◽

Generation Cephalosporin ◽

Neonatal Intensive Care Units ◽

Antibiotic Prescribing ◽

Prescribing Practices ◽

Clinical Vignettes

Objective.To use clinical vignettes to understand antimicrobial prescribing practices in neonatal intensive care units (NICUs).Design.Vignette-based survey.Setting.Four tertiary care NICUs.Participants.Antibiotic prescribers in NICUs.Methods.Clinicians from 4 tertiary care NICUs completed an anonymous survey containing 12 vignettes that described empiric, targeted, or prophylactic antibiotic use. Responses were compared with Centers for Disease Control and Prevention guidelines for appropriate use.Results.Overall, 161 (59% of 271 eligible respondents) completed the survey, 37% of whom had worked in NICUs for 7 or more years. Respondents were more likely to appropriately identify use of targeted therapy for methicillin-susceptible Staphylococcus aureus, that is, use of oxacillin rather than vancomycin, than for Escherichia coli, that is, use of first-generation rather than third-generation cephalosporin, (P < .01). Increased experience significantly predicted appropriate prescribing (P = .02 ). The proportion of respondents choosing appropriate duration of postsurgical prophylaxis (P < .01) and treatment for necrotizing enterocolitis differed by study site (P = .03).Conclusions.The survey provides insight into antibiotic prescribing practices and informs the development of future antibiotic stewardship interventions for NICUs.

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The Effect of Famotidine on Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis

10.1101/2021.03.14.21253537 ◽

2021 ◽

Author(s):

Leonard Chiu ◽

Max Shen ◽

Ronald Chow ◽

Chun-Han Lo ◽

Nicholas Chiu ◽

...

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Observational Studies ◽

Meta Analysis ◽

Hospitalized Patients ◽

H2 Receptor Antagonist ◽

Histamine H2 Receptor ◽

Risk Of Death ◽

Care Services ◽

Potential Efficacy

Introduction: Famotidine is a competitive histamine H2-receptor antagonist most commonly used for gastric acid suppression but thought to have potential efficacy in treating patients with COVID-19. The aims of this systematic review and meta-analysis are to summarize the current literature and report clinical outcomes on the use of famotidine for treatment of hospitalized patients with COVID-19. Methods: Five databases were searched through February 12, 2021 to identify observational studies that reported on associations of famotidine use with outcomes in COVID-19. Meta-analysis was conducted for composite primary clinical outcome (e.g. rate of death, intubation, or intensive care unit admissions) and death separately, where either aggregate odds ratio (OR) or hazard ratio (HR) was calculated. Results: Four studies, reporting on 46,435 total patients and 3,110 patients treated with famotidine, were included in this meta-analysis. There was no significant association between famotidine use and composite outcomes in patients with COVID-19: HR 0.63 (95% CI: 0.35, 1.16). Across the three studies that reported mortality separated from other endpoints, there was no association between famotidine use during hospitalization and risk of death - HR 0.67 (95% CI: 0.26, 1.73) and OR 0.79 (95% CI: 0.19, 3.34). Heterogeneity ranged from 83.69% to 88.07%. Conclusion: Based on the existing observational studies, famotidine use is not associated with a reduced risk of mortality or combined outcome of mortality, intubation, and/or intensive care services in hospitalized individuals with COVID-19, though heterogeneity was high, and point estimates suggested a possible protective effect for the composite outcome that may not have been observed due to lack of power. Further RCTs may help determine the efficacy and safety of famotidine as a treatment for COVID-19 patients in various care settings of the disease

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Face Masks Use to Avoid Airborne Contamination during COVID-19 Pandemic and Related Conditions: A Systematic Review

Iranian Journal of Public Health ◽

10.18502/ijph.v50i12.7920 ◽

2021 ◽

Author(s):

Danúbia da Cunha De Sá-Caputo ◽

Ana Carolina Coelho-Oliveira ◽

Anelise Sonza ◽

Laisa Liane Paineiras-Domingos ◽

Redha Taiar ◽

...

Keyword(s):

Systematic Review ◽

Observational Studies ◽

English Language ◽

Face Mask ◽

Risk Of Bias ◽

Bacterial Suspension ◽

Level Of Evidence ◽

Airborne Contamination ◽

Different Types ◽

The Face

Background: The facemasks use has been discussed to prevent respiratory disease due airborne contamination. The aim of this study was to perform a systematic review about the face masks use to avoid airborne contamination during COVID-19 pandemic and related conditions, registered (PROSPERO-CRD42020198347) and performed according PRISMA. Methods: PubMed, Embase and Scopus databases were used to collect data. Observational studies, published in 2020, and English language, were included. Two reviewers independently identified records through database search and reference screening and disagreements were resolved by a third reviewer. Six studies were included. Results: The works investigated about the use of masks (different types) to prevent droplets dissemination with virus or bacterial suspension and decrease COVID-19 transmission routes, comfort, or temperature. The studies have moderate to critical risk of bias and the level of evidence is III-2. Conclusion: It is recommended facemask use to prevent droplets from escaping airborne and infecting other people, although there are different percentages of protection and can be possible a discomfort related the use. Further clinical trials to the effectiveness of face mask to avoid airborne contamination during the COVID-19 pandemic and the factors interfering with their effectiveness should be conducted.

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