生长不良/发育迟缓的＜6 月龄婴儿常规使用抗生素的系统评价方案

Protocol for a systematic review on routine use of antibiotics for infants less than 6 months of age with growth failure/faltering.

机构信息

Division of Pediatric Gastroenterology, Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, USA

College of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.

出版信息

BMJ Open. 2022 Jun 30;12(6):e057241. doi: 10.1136/bmjopen-2021-057241.

DOI:10.1136/bmjopen-2021-057241

PMID:35772832

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9247651/

Abstract

INTRODUCTION

Antibiotics have been used as an adjunct in treating children with severe acute malnutrition 6-59 months of age; however, the data for infants less than 6 months are scarce. The WHO recently started guideline development for preventing and treating wasting, including growth failure/faltering in infants less than 6 months. This systematic review commissioned by WHO aims to synthesise evidence from current literature on the effectiveness of antibiotics for infants less than 6 months of age with growth failure/faltering.

METHODS AND ANALYSIS

We will conduct a systematic review and meta-analysis for studies that assessed the effect of antibiotics in the treatment of infants with growth faltering. We will search multiple electronic databases. We will include randomised control trials and non-randomised studies with a control arm. The study population is infants less than 6 months of age with growth failure. The intervention group will be infants who received no antibiotics or antibiotics other than recommended in 2013 guidelines by WHO to treat severe acute malnutrition in children. The comparison group will be infants who received antibiotics according to the 2013 guideline by WHO. We will consider the following outcomes: mortality, clinical deterioration, antimicrobial resistance, recovery from comorbidity, adverse events, markers of intestinal inflammation, markers of systemic inflammation, hospital-acquired infections, non-response. We will use the meta-analysis to pool the studies where applicable. We will use the Grading of Recommendations Assessment, Development, and Evaluation approach to reporting the overall evidence quality for an outcome.

ETHICS AND DISSEMINATION

This is a systematic review and will not involve contact with a human subject. The findings of this review will be published in a peer-review journal and will guide the WHO's recommendation for the use of antibiotics in infants less than 6 months of age with growth failure.

PROSPERO REGISTRATION NUMBER

CRD42021277073.

摘要

简介

抗生素已被用作治疗 6-59 个月严重急性营养不良儿童的辅助药物；然而，6 个月以下婴儿的数据却很少。世卫组织最近开始制定预防和治疗消瘦症的指南，包括 6 个月以下婴儿的生长迟缓/发育不良。本项由世卫组织委托进行的系统评价旨在综合当前文献中关于抗生素治疗 6 个月以下生长迟缓/发育不良婴儿的有效性证据。

方法和分析

我们将对评估抗生素治疗生长迟缓婴儿效果的研究进行系统评价和荟萃分析。我们将搜索多个电子数据库。我们将纳入随机对照试验和非随机研究，且这些研究均设有对照组。研究人群为 6 个月以下患有生长迟缓的婴儿。干预组为未接受抗生素治疗或接受世卫组织 2013 年严重急性营养不良儿童治疗指南以外的抗生素治疗的婴儿。对照组为根据世卫组织 2013 年指南接受抗生素治疗的婴儿。我们将考虑以下结局：死亡率、临床恶化、抗生素耐药性、合并症康复、不良事件、肠道炎症标志物、全身炎症标志物、医院获得性感染、无反应。在适用的情况下，我们将使用荟萃分析来汇总研究。我们将使用推荐评估、制定与评估（Grading of Recommendations Assessment, Development, and Evaluation，GRADE）方法来报告总体结局证据质量。