Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol.
Parenteral and oral antibiotic duration for treatment of pediatric osteomyelitis: a systematic review protocol.
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DOI：
10.1186/2046-4053-2-92
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发表时间：
2013-10-07
影响因子：
3.7
通讯作者：
Curtis S
中科院分区：
文献类型：
--
作者：
Grimbly C;Odenbach J;Vandermeer B;Forgie S;Curtis S
小儿骨髓炎是一种细菌感染的骨头，需要长期的抗生素治疗，使用肠外，其次是肠内代理。小儿骨髓炎的主要并发症包括转变为慢性骨髓炎、形成骨膜下脓肿、感染延伸至关节和永久性骨畸形或肢体缩短。从历史上看，骨髓炎一直用长时间的抗生素治疗，以避免这些并发症。然而，随着管理和抗生素治疗的改进，标准治疗正在朝着肠内抗生素之前的静脉内抗生素的短持续时间发展。作者将根据PRISMA指南进行系统综述，以评价文献，寻找支持肠外和肠内治疗最佳持续时间的证据。主要目的是了解文献是否支持肠外抗生素和/或肠内抗生素的较短持续时间。将使用全面检索策略对多个数据库进行研究。数据库包括Medline、科克伦、EMBASE、SCOPUS、论文摘要、CINAHL、Web of Science、非洲医学索引和LILACS。检索流将包括骨髓炎和抗生素治疗儿科患者的医学主题。我们将检索已发表或未发表的随机和半随机对照试验。两名作者将独立选择文章，提取数据并通过标准科克伦方法评估偏倚风险。我们将分析使用风险比的二分结局和使用平均差的连续结局之间的比较。将计算95%置信区间。这种疾病管理的主要难题之一是胃肠外治疗的持续时间。长期肠外治疗增加了严重并发症的风险，长期治疗的必要性受到质疑。我们的研究旨在回顾目前从随机试验中获得的关于小儿急性骨髓炎胃肠外和口服治疗持续时间的证据。CRD42013002320
Pediatric osteomyelitis is a bacterial infection of bones requiring prolonged antibiotic treatment using parenteral followed by enteral agents. Major complications of pediatric osteomyelitis include transition to chronic osteomyelitis, formation of subperiosteal abscesses, extension of infection into the joint, and permanent bony deformity or limb shortening. Historically, osteomyelitis has been treated with long durations of antibiotics to avoid these complications. However, with improvements in management and antibiotic treatment, standard of care is moving towards short durations of intravenous antibiotics prior to enteral antibiotics. The authors will perform a systematic review based on PRISMA guidelines in order to evaluate the literature, looking for evidence to support the optimal duration of parenteral and enteral therapy. The main goals are to see if literature supports shorter durations of either parenteral antibiotics and/or enteral antibiotics. Multiple databases will be investigated using a thorough search strategy. Databases include Medline, Cochrane, EMBASE, SCOPUS, Dissertation Abstracts, CINAHL, Web of Science, African Index Medicus and LILACS. Search stream will include medical subject heading for pediatric patients with osteomyelitis and antibiotic therapy. We will search for published or unpublished randomized and quasi-randomized controlled trials. Two authors will independently select articles, extract data and assess risk of bias by standard Cochrane methodologies. We will analyze comparisons between dichotomous outcomes using risk ratios and continuous outcomes using mean differences. 95% confidence intervals will be computed. One of the major dilemmas of management of this disease is the duration of parenteral therapy. Long parenteral therapy has increased risk of serious complications and the necessity for long therapy has been called into question. Our study aims to review the currently available evidence from randomized trials regarding duration of both parenteral and oral therapy for pediatric acute osteomyelitis. CRD42013002320