Evidence map›Paper›PMID 21836758›Full record

SynthesisBulletin of the World Health Organization2011

Antibiotics in severely malnourished children: systematic review of efficacy, safety and pharmacokinetics.

Marzia Lazzerini, David Tickell

Registry-linked trialOpen access · diamondAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Bulletin of the World Health Organization, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02746276 (Pharmacokinetics of Antimicrobials and Carriage of Antimicrobial Resistance Amongst Hospitalised Children With Severe Acute Malnutrition), which is not on this map. Cited by 33 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 5 pooled it
2.3field-weighted citation impact, top 13% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT02746276 phase2unknown statusnot on this mapstarted 2016, after this paper: background citation

Pharmacokinetics of Antimicrobials and Carriage of Antimicrobial Resistance Amongst Hospitalised Children With Severe Acute Malnutrition

TypeinterventionalSponsorUniversity of OxfordRan2016 to 2017Enrolled81ConditionsMalnutritionArmsCeftriaxone, Metronidazole
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 62 citations in OpenAlex.

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  7. Antibiotics as part of the management of severe acute malnutrition.Malawi medical journal : the journal of Medical Association of Malawi · 2016
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 2 countries.

Marzia LazzeriniInstitute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.
David Tickell
IRCCS Materno Infantile Burlo Garofolo · ITRoyal Children's Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo systemically review the evidence in support of World Health Organization guidelines recommending broad-spectrum antibiotics for children with severe acute malnutrition (SAM).

methodsCENTRAL, MEDLINE, EMBASE, LILACS, POPLINE, CAB Abstracts and ongoing trials registers were searched. Experts were contacted. Conference proceedings and reference lists were manually searched. All study types, except single case reports, were included.

findingsTwo randomized controlled trials (RCTs), one before-and-after study and two retrospective reports on clinical efficacy and safety were retrieved, together with 18 pharmacokinetic studies. Trial quality was generally poor and results could not be pooled due to heterogeneity. Oral amoxicillin for 5 days was as effective as intramuscular ceftriaxone for 2 days (1 RCT). For uncomplicated SAM, amoxicillin showed no benefit over placebo (1 retrospective study). The introduction of a standardized regimen using ampicillin and gentamicin significantly reduced mortality in hospitalized children (odds ratio, OR: 4.0; 95% confidence interval, CI: 1.7-9.8; 1 before-and-after study). Oral chloramphenicol was as effective as trimethoprim-sulfamethoxazole in children with pneumonia (1 RCT). Pharmacokinetic data suggest that normal doses of penicillins, cotrimoxazole and gentamicin are safe in malnourished children, while the dose or frequency of chloramphenicol requires adjustment. Existing evidence is not strong enough to further clarify recommendations for antibiotic treatment in children with SAM.

conclusionLarge RCTs are needed to define optimal antibiotic treatment in children with SAM with and without complications. Further research into gentamicin and chloramphenicol toxicity and into the pharmacokinetics of ceftriaxone and ciprofloxacin is also required.

Indexed as

Anti-Bacterial AgentsChildChild Nutrition DisordersChild, PreschoolHumansSeverity of Illness IndexTreatment OutcomeAnti-Bacterial Agents

Identifiers

PMID21836758
PMCPMC3150757
OpenAlexW2132911097

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.