Comparative effectiveness and complications of intravenous ceftriaxone compared with oral doxycycline in Lyme meningitis in children: a multicentre prospective cohort study.
Comparative effectiveness and complications of intravenous ceftriaxone compared with oral doxycycline in Lyme meningitis in children: a multicentre prospective cohort study.
复制标题
DOI：
10.1136/bmjopen-2022-071141
复制
发表时间：
2023-02-28
期刊：
影响因子：
2.9
通讯作者：
Net, Pedi Lyme
中科院分区：
文献类型：
--
作者：
Nigrovic, Lise E.;Chun, Thomas H.;Vargas, Sara E.;Caffrey, Aisling R.;Halperin, John J.;Race, Jonathan A.;Ott, Ulrike;Morrison, Brynna L.;Fuller, Bethany J.;VanBuren, John M.;Net, Pedi Lyme
莱姆病是北方最常见的病媒传播疾病，在美国每年有超过40万新病例。莱姆病脑膜炎是莱姆病的一种罕见但潜在的严重临床表现。静脉注射头孢曲松是莱姆病脑膜炎的一线治疗方法，但并发症发生率高。尽管口服强力霉素的疗效和有效性（或真实世界证据）数据有限，但最近扩大了实践指南，推荐口服强力霉素或头孢曲松作为莱姆病脑膜炎的一线治疗。我们的目的是比较口服强力霉素和静脉注射头孢曲松治疗莱姆病脑膜炎对短期恢复和长期生活质量的影响。我们正在位于莱姆病流行的不同地理区域的20个美国儿科中心进行一项前瞻性队列研究。临床护理团队将按照惯例为莱姆病脑膜炎儿童做出所有抗生素治疗决定。我们将随访入选儿童6个月，以确定急性症状恢复的时间和对生活质量的影响。波士顿儿童医院是唯一的机构审查委员会（sIRB），已与其他19个入组研究中心以及依赖波士顿儿童医院sIRB的犹他州数据协调中心批准了研究方案。一旦研究完成，我们将在同行评议的医学杂志上发表我们的发现。
Lyme disease is the most common vectorborne disease in the Northern hemisphere with more than 400 000 new cases in the USA annually. Lyme meningitis is an uncommon but potentially serious clinical manifestation of Lyme disease. Intravenous ceftriaxone had been the first-line treatment for Lyme meningitis, but is associated with a high rate of complications. Although efficacy and effectiveness (or real-world evidence) data for oral doxycycline are limited, practice guidelines were recently expanded to recommend either oral doxycycline or ceftriaxone as first-line treatments for Lyme meningitis. Our goal is to compare oral doxycycline with intravenous ceftriaxone for the treatment of Lyme meningitis on short-term recovery and long-term quality of life. We are performing a prospective cohort study at 20 US paediatric centres located in diverse geographical range where Lyme disease is endemic. The clinical care team will make all antibiotic treatment decisions for children with Lyme meningitis, as per usual practice. We will follow enrolled children for 6 months to determine time of acute symptom recovery and impact on quality of life. Boston Children’s Hospital, the single Institutional Review Board (sIRB), has approved the study protocol with the other 19 enrolling sites as well as the Utah data coordinating centre relying on the Boston Children’s Hospital sIRB. Once the study is completed, we will publish our findings in a peer-reviewed medical journal.
登录
查看更多内容
DOI：
10.1093/cid/ciu397
发表时间：
2014-09-01
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Hinckley AF;Connally NP;Meek JI;Johnson BJ;Kemperman MM;Feldman KA;White JL;Mead PS
通讯作者：
Mead PS
影响因子：
158.5
作者：
Freedman, Stephen B.;Williamson-Urquhart, Sarah;Schuh, Suzanne
通讯作者：
Schuh, Suzanne
影响因子：
6
作者：
KOHLHEPP, W;OSCHMANN, P;MERTENS, HG
通讯作者：
MERTENS, HG
影响因子：
--
作者：
Roelf, Kelly M;Garro, Aris;Nigrovic, Lise E
通讯作者：
Nigrovic, Lise E
影响因子：
--
作者：
Saunders B;Sim J;Kingstone T;Baker S;Waterfield J;Bartlam B;Burroughs H;Jinks C
通讯作者：
Jinks C