Evidence map›Paper›PMID 29049353›Full record

SynthesisPloS one2017

Should preventive antibiotics be used in patients with acute stroke? A systematic review and meta-analysis of randomized controlled trials.

Feng Zheng, Niklas von Spreckelsen, Xintong Zhang, Pantelis Stavrinou, Marco Timmer, Christian Dohmen, Roland Goldbrunner, Fang Cao, Qiang Zhang, Qishan Ran and 4 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.2field-weighted citation impact, top 20% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Review
  6. Healthcare-Associated Infections in the Neurocritical Care Unit.Current neurology and neuroscience reports · 2019
    Review
  7. Review
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

14 authors at 4 institutions in 2 countries.

Feng ZhengDepartment of Neurosurgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.ORCID http://orcid.org/0000-0002-4428-4450
Niklas von SpreckelsenDepartment of Neurosurgery, University Hospital of Cologne, Cologne, Germany.
Xintong ZhangDepartment of Neurosurgery, The Second Clinical Medical School of Inner Mongolia University for the Nationalities (Inner Mongolia Forestry General Hospital), Inner Mongolia, China.
Pantelis StavrinouDepartment of Neurosurgery, University Hospital of Cologne, Cologne, Germany.
Marco TimmerDepartment of Neurosurgery, University Hospital of Cologne, Cologne, Germany.
Christian DohmenDepartment of Neurology, University Hospital of Cologne, Cologne, Germany.
Roland GoldbrunnerDepartment of Neurosurgery, University Hospital of Cologne, Cologne, Germany.
Fang CaoDepartment of Cerebrovascular Disease, the first affiliated hospital of Zunyi Medical College, Zunyi, Guizhou, China.
Qiang ZhangDepartment of Cerebrovascular Disease, the first affiliated hospital of Zunyi Medical College, Zunyi, Guizhou, China.
Qishan RanDepartment of Cerebrovascular Disease, the first affiliated hospital of Zunyi Medical College, Zunyi, Guizhou, China.
Gang LiDepartment of Cerebrovascular Disease, the first affiliated hospital of Zunyi Medical College, Zunyi, Guizhou, China.
Ruiming FanDepartment of Cerebrovascular Disease, the first affiliated hospital of Zunyi Medical College, Zunyi, Guizhou, China.
Shengtao YaoDepartment of Cerebrovascular Disease, the first affiliated hospital of Zunyi Medical College, Zunyi, Guizhou, China.
Boris KrischekDepartment of Neurosurgery, University Hospital of Cologne, Cologne, Germany.
Affiliated Hospital of Zunyi Medical College · CNUniversity Hospital Cologne · DEGuangdong Medical College · CNInner Mongolia University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInfection is a common complication in acute stroke. Whether or not preventive antibiotics reduce the risk of infection or even lead to a favorable outcome and reduction of mortality after a stroke still remains equivocal. This review was performed to update the current knowledge on the effect and possible benefits of prophylactic antibiotic therapy in patients with stroke.

methodsA systematic review and meta-analysis of preventive antibiotics`effect on the incidence of infection, favorable outcome (mRS≤2) and mortality in patients with acute stroke is performed with relevant randomized controlled trials.

resultsSix studies were identified, involving 4125 participants. Compared with the control group, the treated groups were significantly less prone to suffer from early overall infections [RR = 0.52, 95%CI (0.39, 0.70), p<0.0001], early pneumonia [RR = 0.64, 95%CI (0.42, 0.96), p = 0.03] and early urinary tract infections [RR = 0.35, 95%CI (0.25, 0.48), p<0.00001]. However, there was no significant difference in overall mortality [RR = 1.07, 95%CI (0.90, 1.27), p = 0.44], early mortality [RR = 0.99, 95%CI (0.78, 1.26), p = 0.92], late mortality [RR = 1.12, 95%CI (0.94, 1.35), p = 0.21] or favorable outcome [RR = 1.00, 95%CI (0.92, 1.08), p = 0.98].

conclusionAlthough preventive antibiotic treatment did reduce the occurrence of early overall infections, early pneumonia and early urinary tract infection in patients with acute stroke, this advantage was not eventually translated to a favorable outcome and reduction in mortality. Future studies are warranted to identify any subgroup of stroke patients who might benefit from preventive antibiotic treatment.

Indexed as

Randomized Controlled Trials as TopicAcute DiseaseAnti-Bacterial AgentsHumansStrokeAnti-Bacterial Agents

Identifiers

PMID29049353
PMCPMC5648227
OpenAlexW2766689867

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.