Evidence map›Paper›PMID 29033034›Full record

SynthesisThe Lancet. Infectious diseases2018

Antimicrobial resistance among children in sub-Saharan Africa.

Phoebe C M Williams, David Isaacs, James A Berkley

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

Synthesis in The Lancet. Infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03174236 (First Line Antimicrobials in Children With Complicated Severe Acute Malnutrition), which is not on this map. Cited by 98 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
98citing papers in PubMed, 9 pooled it
9.8field-weighted citation impact, top 1% 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.

NCT03174236 phase3unknown statusnot on this map

First Line Antimicrobials in Children With Complicated Severe Acute Malnutrition

TypeinterventionalSponsorUniversity of OxfordRan2017 to 2020Enrolled2,000ConditionsMalnutrition Severe, Antibiotic Resistance, Antibiotic ToxicityArmsCeftriaxone, Benzyl penicillin, Metronidazole, Placebo, Gentamicin
3 · Its place in the literature

Who cites it

98 citing papers in PubMed, 9 syntheses or guidelines pooled it, 170 citations in OpenAlex.

  1. Pooled it
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  11. Gut Resistome After Oral Antibiotics in Preschool Children in Burkina Faso: A Randomized, Controlled Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020
    Trial
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  20. BMJ paediatrics open · 2026
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38 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 3 countries.

Phoebe C M WilliamsNuffield Department of Medicine, The University of Oxford, Oxford, UK. Electronic address: phoebe.williams@univ.ox.ac.uk.
David IsaacsDepartment of Infectious Diseases & Microbiology, Children's Hospital at Westmead, Westmead, NSW, Australia.
James A BerkleyKenya Medical Research Institute (KEMRI)/Wellcome Trust Research Programme, Kilifi, Kenya; The Childhood Acute Illness & Nutrition (CHAIN) Network, Kilifi, Kenya; Centre for Tropical Medicine & Global Health, Nuffield Department of Medicine, The University of Oxford, Oxford, UK.
Children's Hospital at Westmead · AUThe Childhood Acute Illness and Nutrition Network · KEUniversity of Oxford · GB

Funding

Medical Research Council MR/M007367/1Wellcome Trust
6 · The paper itself

Abstract

Antimicrobial resistance is an important threat to international health. Therapeutic guidelines for empirical treatment of common life-threatening infections depend on available information regarding microbial aetiology and antimicrobial susceptibility, but sub-Saharan Africa lacks diagnostic capacity and antimicrobial resistance surveillance. We systematically reviewed studies of antimicrobial resistance among children in sub-Saharan Africa since 2005. 18 of 1075 articles reviewed met inclusion criteria, providing data from 67 451 invasive bacterial isolates from inconsistently defined populations in predominantly urban tertiary settings. Among neonates, Gram-negative organisms were the predominant cause of early-onset neonatal sepsis, with a high prevalence of extended-spectrum β-lactamase-producing organisms. Gram-positive bacteria were responsible for a high proportion of infections among children beyond the neon atal period, with high reported prevalence of non-susceptibility to treatment advocated by the WHO therapeutic guidelines. There are few up-to-date or representative studies given the magnitude of the problem of antimicrobial resistance, especially regarding community-acquired infections. Research should focus on differentiating resistance in community-acquired versus hospital-acquired infections, implementation of standardised reporting systems, and pragmatic clinical trials to assess the efficacy of alternative treatment regimens.

Indexed as

Drug Resistance, BacterialAdolescentAfrica South of the SaharaBacterial InfectionsChildChild, PreschoolGram-Negative BacteriaGram-Positive BacteriaHumansInfantInfant, NewbornMicrobial Sensitivity TestsPrevalence

Identifiers

PMID29033034
PMCPMC5805911
OpenAlexW2762407815

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.