Evidence map›Paper›PMID 33004385›Full record

ArticleBMJ open2020

Strategies to reduce antibiotic use in women with uncomplicated urinary tract infection in primary care: protocol of a systematic review and meta-analysis including individual patient data.

Judith Heinz, Christian Röver, Ghefar Furaijat, Yvonne Kaußner, Eva Hummers, Thomas Debray, Alastair D Hay, Stefan Heytens, Ingvild Vik, Paul Little and 9 more

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.7field-weighted citation impact, top 28% 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, 6 citations in OpenAlex.

  1. Review
  2. Article
  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

19 authors at 10 institutions in 9 countries.

Judith Heinz *Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany judith.heinz@med.uni-goettingen.de.ORCID 0000-0001-8331-9137
Christian Röver *Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany.
Ghefar FuraijatDepartment of General Practice, University Medical Center Goettingen, Goettingen, Germany.
Yvonne KaußnerDepartment of General Practice, Julius Maximilians University Wuerzburg Faculty of Medicine, Wuerzburg, Germany.
Eva HummersDepartment of General Practice, University Medical Center Goettingen, Goettingen, Germany.
Thomas DebrayJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Alastair D HayCentre for Academic Primary Care, University of Bristol, Bristol, UK.
Stefan HeytensDepartment of Public Health and Primary Care, University of Ghent, Gent, Belgium.
Ingvild VikDepartment of General Practice, The Antibiotic Centre of Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.ORCID 0000-0002-8947-2914
Paul LittlePrimary Care Population Sciences and Medical Education Unit, University of Southampton School of Medicine, Southampton, UK.ORCID 0000-0003-3664-1873
Michael MoorePrimary Care Population Sciences and Medical Education Unit, University of Southampton School of Medicine, Southampton, UK.ORCID 0000-0002-5127-4509
Beth StuartPrimary Care Population Sciences and Medical Education Unit, University of Southampton School of Medicine, Southampton, UK.
Florian WagenlehnerClinic for Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen Faculty of Medicine, Giessen, Germany.
Andreas KronenbergInstitute for Infectious Diseases, University of Bern, Bern, Switzerland.
Sven FerryDepartment of Clinical Microbiology, Bacteriology, Umea University, Umea, Sweden.
Tor MonsenDepartment of Clinical Microbiology, Bacteriology, Umea University, Umea, Sweden.
Morten LindbaekDepartment of General Practice, The Antibiotic Centre of Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
Tim FriedeDepartment of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany.ORCID 0000-0001-5347-7441
Ildiko GagyorDepartment of General Practice, Julius Maximilians University Wuerzburg Faculty of Medicine, Wuerzburg, Germany.ORCID 0000-0002-7974-7603
University Medical Center · USPrimary Health Care · QAUmeå University · SEUniversity of Oslo · NOUniversity of Würzburg · DEGhent University · BEJustus-Liebig-Universität Gießen · DEUniversity Medical Center Utrecht · NLUniversity of Bern · CHUniversity of Bristol · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionUncomplicated urinary tract infection (UTI) in women is a common reason to present in general practice and is usually treated with antibiotics to reduce symptom severity and duration. Results of recent clinical trials indicate that non-antibiotic treatment approaches can also be effective. However, it remains unclear which patients would benefit from antibiotic treatment and which can effectively and safely be treated without antibiotics. This systematic review and meta-analysis aims to estimate the effect of treatment strategies to reduce antibiotic use in comparison with immediate antibiotic treatment and to identify prognostic factors and moderators of treatment effects. A further aim is to identify subgroups of patients benefiting from a specific therapy. METHODS AND ANALYSIS: A systematic literature search will be performed to identify randomised controlled trials which investigated the effect of treatment strategies to reduce antibiotic use in female adults with uncomplicated UTI compared with immediate antibiotic treatment. Therefore, the primary outcome of the meta-analysis is incomplete recovery. Anonymised individual patient data (IPD) will be collected. Aggregate data will be used for pairwise comparisons of treatment strategies using meta-analysis models with random effects accounting for potential between-study heterogeneity. Potential effect moderators will be explored in meta-regressions. For IPD, generalised linear mixed models will be used, which may be adjusted for baseline characteristics. Interactions of baseline variables with treatment effects will be explored. These models will be used to assess direct comparisons of treatment, but might be extended to networks. ETHICS AND DISSEMINATION: The local institutional review and ethics board judged the project a secondary analysis of existing anonymous data which meet the criteria for waiver of ethics review. Dissemination of the results will be via published scientific papers and presentations. Key messages will be promoted for example, via social media or press releases. PROSPERO REGISTRATION NUMBER: CRD42019125804.

Indexed as

Anti-Bacterial AgentsUrinary Tract InfectionsAdultFemaleHumansMeta-Analysis as TopicPrimary Health CareSystematic Reviews as TopicAnti-Bacterial Agentsadult urologygeneral medicine (see internal medicine)urinary tract infections

Identifiers

PMID33004385
PMCPMC7534728
OpenAlexW3042704438

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.