Evidence map›Paper›PMID 34983426›Full record

ArticleBMC infectious diseases2022

Evaluation of the current guidelines for antibacterial therapy strategies in patients with cirrhosis or liver failure.

Yuzhu Dong, Dan Sun, Yan Wang, Qian Du, Ying Zhang, Ruiying Han, Mengmeng Teng, Tao Zhang, Lei Shi, Gezhi Zheng and 2 more

Open access · goldAbstract read
In one paragraph

Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
  6. Review
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  8. 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

12 authors at 3 institutions in 1 country.

Yuzhu DongDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Dan SunDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Yan WangDepartment of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Qian DuDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Ying ZhangDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Ruiying HanDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Mengmeng TengDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Tao ZhangDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Lei ShiDepartment of Infections, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Gezhi ZhengDepartment of Infections, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Yalin DongDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China. dongyalin@mail.xjtu.edu.cn.
Taotao WangDepartment of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China. wangtaotao1989@mail.xjtu.edu.cn.
First Affiliated Hospital of Xi'an Jiaotong University · CNChongqing Medical University · CNSecond Affiliated Hospital of Xi'an Jiaotong University · CN

Funding

National Natural Science Foundation of China 71904155the Fundamental Research Funds for the Central Universities xzy012019079the key research and development program in Shaanxi province of China 2019ZDLSF01-05the Key Research and Development Program of Shaanxi 2020SF-064
6 · The paper itself

Abstract

backgroundBacterial infections are common complications in patients with cirrhosis or liver failure and are correlated with high mortality. Clinical practice guideline (CPG) is a reference used to help clinicians make decisions. This systematic appraisal aimed to evaluate the methodological quality and summarize the recommendations of reported CPGs in these patients.

methodsWe systematically searched CPGs published from 2008 to 2019. The methodological quality of the included CPGs was assessed using the AGREE II instrument. We extracted and compared recommendations for prophylactic and empirical treatment strategies.

resultsFourteen CPGs with a median overall score of 56.3% were included. The highest domain score was Clarity of Presentation (domain 4, 85.4%), and the lowest was for Stakeholder Involvement (domain 2, 31.3%). Three CPGs had an overall score above 80%, and 6 CPGs had a score above 90% in domain 4. Prophylaxis should be strictly limited to patients with varicose bleeding, low ascites protein levels and a history of spontaneous bacterial peritonitis. Fluoroquinolones (norfloxacin and ciprofloxacin), third-generation cephalosporins (G3) (ceftriaxone and cefotaxime) and trimethoprim-sulfamethoxazole (SXT) are recommended for preventing infections in patients with cirrhosis or liver failure. G3, β-lactam/β-lactamase inhibitor combinations (BLBLIs) and carbapenems are recommended as the first choice in empirical treatment according to local epidemiology of bacterial resistance.

conclusionsThe methodological quality of CPGs focused on patients with cirrhosis or liver failure evaluated by the AGREE II instrument is generally poor. Three CPGs that were considered applicable without modification and 6 CPGs that scored above 90% in domain 4 should also be paid more attention to by healthcare practitioners. Regarding recommendations, norfloxacin, ciprofloxacin, ceftriaxone, cefotaxime, and SXT are recommended for prophylactic treatment appropriately. G3, BLBLIs, and carbapenems are recommended for use in empirical treatment strategies.

Indexed as

Anti-Bacterial AgentsLiver FailureCefotaximeCiprofloxacinHumansLiver CirrhosisAnti-Bacterial AgentsCefotaximeCiprofloxacinAGREE IIBacterial infectionsCirrhosisClinical practice guidelineLiver failure

Identifiers

PMID34983426
PMCPMC8725452
OpenAlexW4205113021

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.