Evidence map›Paper›PMID 31912627›Full record

ArticleTropical medicine & international health : TM & IH2020

Association between treatment with oral third-generation cephalosporin antibiotics and mortality outcomes in Ebola virus disease: a multinational retrospective cohort study.

Adam R Aluisio, Shiromi M Perera, Derrick Yam, Stephanie Garbern, Jillian L Peters, Logan Abel, Daniel K Cho, Dayan Woldemichael, Stephen B Kennedy, Moses Massaquoi and 3 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Tropical medicine & international health : TM & IH, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.1field-weighted citation impact, top 55% 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
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

13 authors at 5 institutions in 3 countries.

Adam R AluisioDepartment of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Shiromi M PereraInternational Medical Corps, Washington, DC, USA.
Derrick YamCenter for Statistical Sciences, Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA.
Stephanie GarbernDepartment of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Jillian L PetersWarren Alpert Medical School of Brown University, Providence, RI, USA.
Logan AbelWarren Alpert Medical School of Brown University, Providence, RI, USA.
Daniel K ChoWarren Alpert Medical School of Brown University, Providence, RI, USA.
Dayan WoldemichaelInternational Medical Corps, Washington, DC, USA.
Stephen B KennedyMinistry of Health, Monrovia, Liberia.
Moses MassaquoiMinistry of Health, Monrovia, Liberia.
Foday SahrCollege of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
Tao LiuCenter for Statistical Sciences, Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA.
Adam C LevineDepartment of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
Brown University · USInternational Medical Corps · USMinistry of Health and Social Welfare · LRUniversity of Liberia · LRUniversity of Sierra Leone · SL

Funding

Emerging Infectious Disease Scholars at Brown UniversityR25AI140490 · NIAID · BROWN UNIVERSITY · PI Silvia Shinpei Chiang · 2018 to 2026
$3.0M
Evaluation of Management Strategies for Maximizing Supportive Care for Patients with Ebola Virus DiseaseR03AI132801 · NIAID · RHODE ISLAND HOSPITAL · PI LEVINE, ADAM CARL · 2017 to 2018
$179k
National Institute of Allergy and Infectious DiseasesNIAID NIH HHS R03 AI132801NIAID NIH HHS R25 AI140490NIH HHS R03AI132801NIH HHS R25AI140490
6 · The paper itself

Abstract

objectiveTo evaluate the association between oral third-generation cephalosporin antibiotic treatment and mortality in Ebola virus disease (EVD).

methodsThis retrospective cohort studied EVD-infected patients admitted to five Ebola Treatment Units in Sierra Leone and Liberia during 2014-15. Empiric treatment with cefixime 400 mg once daily for five days was the clinical protocol; however, due to resource variability, only a subset of patients received treatment. Data on sociodemographics, clinical characteristics, malaria status and Ebola viral loads were collected. The primary outcome was mortality compared between cases treated with cefixime within 48 h of admission to those not treated within 48 h. Propensity scores were derived using clinical covariates. Mortality between treated and untreated cases was compared using propensity-matched conditional logistic regression and bootstrapped log-linear regression analyses to calculate an odds ratio (OR) and relative risk (RR), respectively, with associated 95% confidence intervals (CI).

resultsOf 424 cases analysed, 360 (84.9%) met the cefixime treatment definition. The mean age was 30.5 years and 40.3% were male. Median cefixime treatment duration was 4 days (IQR: 3, 5). Among cefixime-treated patients, mortality was 54.7% (95% CI: 49.6-59.8%) vs. 73.4% (95% CI: 61.5-82.7%) in untreated patients. In conditional logistic regression, mortality likelihood was significantly lower among cases receiving cefixime (OR = 0.48, 95% CI: 0.32-0.71; P = 0.01). In the bootstrap analysis, a non-significant risk reduction was found with cefixime treatment (RR = 0.82, 95% CI: 0.64-1.16, P = 0.11).

conclusionEarly oral cefixime may be associated with reduced mortality in EVD and warrants further investigation.

Indexed as

Administration, OralAdultAnti-Bacterial AgentsCefiximeCohort StudiesDisease OutbreaksFemaleHemorrhagic Fever, EbolaHumansLiberiaMaleRetrospective StudiesRisk FactorsSierra LeoneSurvival AnalysisAnti-Bacterial AgentsCefiximeantibioticsantibiotiquescephalosporincéphalosporinecohort studyEbola virusétude de cohortefièvres hémorragiques viralesviral haemorrhagic feversvirus Ebola

Identifiers

PMID31912627
PMCPMC7176519
OpenAlexW2999220187

What OpenQuestion holds

Textmetadata
LicenceTDM
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.