ArticleBMC public health2009
Pre-hospital antibiotic treatment and mortality caused by invasive meningococcal disease, adjusting for indication bias.
Article in BMC public health, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pre-admission antibiotics for suspected cases of meningococcal disease.The Cochrane database of systematic reviews · 2017Pooled it
- Invasive meningococcal disease in older adults in North America and Europe: is this the time for action? A review of the literature.BMC public health · 2022Review
- Impact of pre-hospital antibiotic therapy on mortality in invasive meningococcal disease: a propensity score study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Observational
- [The golden hour of sepsis: initial therapy should start in the prehospital setting].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Review
- Meningococcal meningitis.Current treatment options in neurology · 2010Article
- Cellular and molecular biology of Neisseria meningitidis colonization and invasive disease.Clinical science (London, England : 1979) · 2010Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMortality from invasive meningococcal disease (IMD) has remained stable over the last thirty years and it is unclear whether pre-hospital antibiotherapy actually produces a decrease in this mortality. Our aim was to examine whether pre-hospital oral antibiotherapy reduces mortality from IMD, adjusting for indication bias.
methodsA retrospective analysis was made of clinical reports of all patients (n = 848) diagnosed with IMD from 1995 to 2000 in Andalusia and the Canary Islands, Spain, and of the relationship between the use of pre-hospital oral antibiotherapy and mortality. Indication bias was controlled for by the propensity score technique, and a multivariate analysis was performed to determine the probability of each patient receiving antibiotics, according to the symptoms identified before admission. Data on in-hospital death, use of antibiotics and demographic variables were collected. A logistic regression analysis was then carried out, using death as the dependent variable, and pre-hospital antibiotic use, age, time from onset of symptoms to parenteral antibiotics and the propensity score as independent variables.
resultsData were recorded on 848 patients, 49 (5.72%) of whom died. Of the total number of patients, 226 had received oral antibiotics before admission, mainly betalactams during the previous 48 hours. After adjusting the association between the use of antibiotics and death for age, time between onset of symptoms and in-hospital antibiotic treatment, pre-hospital oral antibiotherapy remained a significant protective factor (Odds Ratio for death 0.37, 95% confidence interval 0.15-0.93).
conclusionPre-hospital oral antibiotherapy appears to reduce IMD mortality.
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