Adjuvant therapy in neonatal sepsis to prevent mortality - A systematic review and network meta-analysis
Rattachement africain : in, ca. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Despite appropriate antibiotic therapy, the risk of mortality in neonatal sepsis still remains high. We conducted a systematic review to comprehensively evaluate different adjuvant therapies in neonatal sepsis in a network meta-analysis. METHODS: We included randomized controlled trials (RCTs) and quasi-RCTs that evaluated adjuvant therapies in neonatal sepsis. Neonates of all gestational and postnatal ages, who were diagnosed with sepsis based on blood culture or sepsis screen were included. We searched MEDLINE, CENTRAL, EMBASE and CINAHL until 12th April 2021 and reference lists. Data extraction and risk of bias assessment were performed in duplicate. A network meta-analysis with bayesian random-effects model was used for data synthesis. Certainty of evidence (CoE) was assessed using GRADE. RESULTS: We included 45 studies involving 6,566 neonates. Moderate CoE showed IVIG [Relative Risk (RR); 95% Credible Interval (CrI): 1.00; (0.67-1.53)] as an adjunctive therapy probably does not reduce all-cause mortality before discharge, compared to standard care. Melatonin [0.12 (0-0.08)] and granulocyte transfusion [0.39 (0.19-0.76)] may reduce mortality before discharge, but CoE is very low. The evidence is also very uncertain regarding other adjunctive therapies to reduce mortality before discharge. Pentoxifylline may decrease the duration of hospital stay [Mean difference; 95% CrI: -7.48 days (-14.50-0.37)], but CoE is very low. CONCLUSION: Given the biological plausibility for possible efficacy of these adjuvant therapies and that the CoE from the available trials is very low to low except for IVIG, we need large adequately powered RCTs to evaluate these therapies in sepsis in neonates.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Adjuvant therapy in neonatal sepsis to prevent mortality - A systematic review and network meta-analysis
- Date Crossref
- 23/12/2022
- Éditeur
- SAGE Publications
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
PSG Institute of Medical Sciences & Research pays non établi dans la noticeÉtablissement de santé
-
Niloufer Hospital pays non établi dans la noticeÉtablissement de santé
-
Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital pays non établi dans la noticeOrganisme public
-
Post Graduate Institute of Medical Education and Research Departmentof Neonatology pays non établi dans la noticeUniversité ou école supérieure
-
All India Institute of Medical Sciences Department of Neonatology pays non établi dans la noticeUniversité ou école supérieure
-
Queen's University Health Sciences Librarian pays non établi dans la noticeUniversité ou école supérieure
-
KMCH Institute of Health Sciences and Research Associate Professor of Neonatology pays non établi dans la noticeStructure de recherche
-
Ankura Hospital for Women and Children Consultant Neonatologist pays non établi dans la noticeÉtablissement de santé
-
Paramitha Children’s Hospital Consultant Neonatologist pays non établi dans la noticeÉtablissement de santé
-
Emirates Specialty Hospital Consultant Neonatologist and Head of Department pays non établi dans la noticeÉtablissement de santé
PSG Institute of Medical Sciences & Research, Niloufer Hospital et Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, avec 7 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.