Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Postgraduate Program - Master of Hospital Administration, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia.
BMJ Open. 2024 Oct 29;14(10):e085593. doi: 10.1136/bmjopen-2024-085593.
Invasive fungal infections (IFIs) significantly impact immunocompromised paediatric patients, contributing to high rates of morbidity and mortality. Despite the evolution of antifungal therapy, the efficacy and safety of combination antifungal therapies in paediatric patients, especially those with haematological malignancies, remain controversial. This systematic review and meta-analysis seeks to critically evaluate the efficacy and safety of antifungal combinations in paediatric IFIs.
We will conduct a search in PubMed, ScienceDirect, Cochrane Library, BMJ and Springer databases to include randomised controlled trials and observational studies focused on combination antifungal therapies in paediatric patients under 18 years with IFIs, using COVIDENCE for data management and analysis, ensuring rigorous quality assessment and statistical integrity in synthesising data. The time frame for the search will encompass publications from the inception of each database to the present, ensuring a comprehensive coverage of the literature. The database search will not be restricted by date. The review will assess combined antifungal treatment against placebo or single-antifungal therapy, examining outcomes like response rates, survival, mortality, adverse effects, cost-effectiveness and quality of life.
The review will be disseminated to healthcare professionals, community groups and policy-makers via journal publication and conference presentations to help them tailor antifungal prophylaxis treatment and outcomes for paediatric patients with IFIs. The analysis will not include any individual patient data, so ethical approval is not required.
CRD42024503620.
侵袭性真菌感染（IFI）对免疫功能低下的儿科患者影响重大，导致发病率和死亡率居高不下。尽管抗真菌治疗不断发展，但联合抗真菌治疗在儿科患者中的疗效和安全性，尤其是在血液病恶性肿瘤患者中，仍存在争议。本系统评价和荟萃分析旨在批判性评估联合抗真菌治疗在儿科IFI 中的疗效和安全性。
我们将在 PubMed、ScienceDirect、Cochrane 图书馆、BMJ 和 Springer 数据库中进行检索，纳入针对 18 岁以下患有 IFI 的儿科患者的联合抗真菌治疗的随机对照试验和观察性研究，使用 COVIDENCE 进行数据管理和分析，确保在综合数据时严格评估质量和统计完整性。检索时间范围将涵盖每个数据库创建以来的出版物，以确保全面涵盖文献。数据库检索不会受到日期的限制。该综述将评估联合抗真菌治疗与安慰剂或单种抗真菌治疗的效果，检查反应率、生存率、死亡率、不良反应、成本效益和生活质量等结局。
本综述将通过期刊发表和会议报告传播给医疗保健专业人员、社区团体和决策者，以帮助他们针对儿科IFI 患者调整抗真菌预防治疗和结局。分析将不包括任何个体患者数据，因此不需要伦理批准。
PROSPERO 注册号：CRD42024503620。
