ArticleEuropean stroke journal2021
Preventive antibiotic therapy in acute stroke patients: A systematic review and meta-analysis of individual patient data of randomized controlled trials.
Article in European stroke journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- European stroke organisation guideline on stroke-associated pneumonia.European stroke journal · 2026Guideline
- Comparison of six risk scores for stroke-associated pneumonia in patients with acute ischemic stroke: A systematic review and Bayesian network meta-analysis.Frontiers in medicine · 2022Pooled it
- Preventive ceftriaxone in patients at high risk of stroke-associated pneumonia. A post-hoc analysis of the PASS trial.PloS one · 2022Trial
- Stroke-associated pneumonia: from immunodepression to bedside management and future research directions.Neurological research and practice · 2026Review
- Microbiota, systemic immunity, and extracellular vesicles in stroke: peripheral nodes as therapeutic leverage points.Journal of neuroinflammation · 2026Review
- Antibiotic Prophylaxis in Neuroendovascular Procedures: A Comprehensive Review.Current neurology and neuroscience reports · 2026Review
- Gut Microbiota and Stroke: New Insights into the Gut-Brain-Vascular Axis.Current atherosclerosis reports · 2026Review
- Early Complications After Mild to Moderate Ischemic Stroke and Impact on 3-Month Outcome: The Multicenter Prospective Stroke Unit Plus Cohort Study.Journal of the American Heart Association · 2025Article
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- Article
- Gut Microbiota, Bacterial Translocation, and Stroke: Current Knowledge and Future Directions.Biomedicines · 2024Review
- A Single-Center Retrospective Study of Bacterial Infections After Acute Ischemic Stroke: The Prevalence Before and During the COVID-19 Pandemic.Medicina (Kaunas, Lithuania) · 2024Article
- Fibrinaloid Microclots and Atrial Fibrillation.Biomedicines · 2024Review
- Stroke-associated pneumonia according to mCDC criteria: impact on prognosis and antibiotic therapy.Frontiers in neurology · 2024Article
- Prevention of infections and fever to improve outcome in older patients with acute stroke (PRECIOUS): a randomised, open, phase III, multifactorial, clinical trial with blinded outcome assessment.The Lancet regional health. Europe · 2024Article
- Does stroke-associated pneumonia play an important role on risk of in-hospital mortality associated with severe stroke? A four-way decomposition analysis of a national cohort of stroke patients.International journal of stroke : official journal of the International Stroke Society · 2023Article
- Article
- The gut-brain axis in ischemic stroke: its relevance in pathology and as a therapeutic target.Neurological research and practice · 2022Review
- Ischemic stroke and concomitant gastrointestinal complications- a fatal combination for patient recovery.Frontiers in immunology · 2022Review
- Application of machine learning and natural language processing for predicting stroke-associated pneumonia.Frontiers in public health · 2022Article
Corrections and comments
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Authors and funding
17 authors at 13 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Infection after stroke is associated with unfavorable outcome. Randomized controlled studies did not show benefit of preventive antibiotics in stroke but lacked power for subgroup analyses. Aim of this study is to assess whether preventive antibiotic therapy after stroke improves functional outcome for specific patient groups in an individual patient data meta-analysis. Patients and methods: We searched MEDLINE (1946-7 May 2021), Embase (1947-7 May 2021), CENTRAL (17th September 2021), trial registries, cross-checked references and contacted researchers for randomized controlled trials of preventive antibiotic therapy versus placebo or standard care in ischemic or hemorrhagic stroke patients. Meta-analysis was performed by a one-step and two-step approach. Primary outcome was functional outcome adjusted for age and stroke severity. Secondary outcomes were infections and mortality. Results: 4197 patients from nine trials were included. Preventive antibiotic therapy was not associated with a shift in functional outcome (mRS) at 3 months (OR1.13, 95%CI 0.98-1.31) or unfavorable functional outcome (mRS 3-6) (OR0.85, 95%CI 0.60-1.19). Preventive antibiotics did not improve functional outcome in pre-defined subgroups (age, stroke severity, timing and type of antibiotic therapy, pneumonia prediction scores, dysphagia, type of stroke, and type of trial). Preventive antibiotics reduced infections (276/2066 (13.4%) in the preventive antibiotic group vs. 417/2059 (20.3%) in the control group, OR 0.60, 95% CI 0.51-0.71, Discussion and conclusion: Preventive antibiotic therapy did not benefit any subgroup of patients with acute stroke and currently cannot be recommended.
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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.