Evidence map›Paper›PMID 36168346›Full record

ReviewCureus2022

Oral Nystatin Prophylaxis for the Prevention of Fungal Colonization in Very Low Birth Weight Infants: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abdulrahman Al-Matary, Lina Almahmoud, Raneem Masmoum, Sultan Alenezi, Salem Aldhafiri, Abdullah Almutairi, Hussain Alatram, Athbi Alenzi, Mohammed Alajm, Ali Artam Alajmi and 5 more

Abstract readReview
In one paragraph

Review in Cureus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Review
  2. Review
  3. 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

15 authors.

Abdulrahman Al-MataryNeonatology, King Fahad Medical City, Riyadh, SAU.
Lina AlmahmoudGeneral Practice, Faculty of Medicine, The Hashemite University, Zarqa, JOR.
Raneem MasmoumCollege of Medicine, Alfaisal University, Riyadh, SAU.
Sultan AleneziPediatrics, Jahra Hospital, Al Jahra, KWT.
Salem AldhafiriPediatrics, Jahra Hospital, Al Jahra, KWT.
Abdullah AlmutairiGeneral Practice, Faculty of Medicine, Kuwait Institute for Medical Specializations, Kuwait City, KWT.
Hussain AlatramEmergency Department, Adan Hospital, Al-Ahmadi, KWT.
Athbi AlenziEmergency Department, Adan Hospital, Al-Ahmadi, KWT.
Mohammed AlajmPediatrics, Faculty of Medicine, Kuwait Institute for Medical Specializations, Kuwait City, KWT.
Ali Artam AlajmiPediatrics, Faculty of Medicine, Kuwait Institute for Medical Specializations, Kuwait City, KWT.
Hadil AlkahmousCollege of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.
Fulwah A AlangariCollege of Medicine, Alfaisal University, Riyadh, SAU.
Abdulrahman AlAnziMedicine, Jordan University of Science and Technology, Irbid, JOR.
Salihah GhazwaniPediatrics, King Khalid University Hospital, Riyadh, SAU.
Ahmed Abu-ZaidInternal Medicine, College of Graduate Health Sciences, The University of Tennessee Health Science Center, Memphis, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We conducted this systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the prophylactic role of oral nystatin in the prevention of fungal colonization in very low birth weight (VLBW) infants compared with placebo or no treatment intervention. From inception until June 2022, we screened four major databases for pertinent RCTs and examined their risk of bias. The main outcomes were the rate of fungal colonization, rate of invasive fungal infection, rate of mortality, mean length of stay in the neonatal intensive care unit (NICU), and mean duration of antibiotic treatment. We summarized data as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI), using the fixed-effects model. Five RCTs met our inclusion criteria. One RCT was evaluated as having "high risk," one RCT was evaluated as having "some concerns," and three RCTs were evaluated as having "low risk" of bias. Compared with the control group, oral nystatin prophylaxis was correlated with substantial decrease in the frequency of fungal colonization (n=4 RCTs, RR=0.34, 95% CI {0.24, 0.48}, p<0.0001), the rate of invasive fungal infection (n=4 RCTs, RR=0.15, 95% CI {0.12, 0.19}, p<0.0001), and the mean duration of antibiotic treatment (n=3 RCTs, MD=-2.79 days, 95% CI {-5.01, -0.56}, p=0.01). However, there was no significant difference between both groups regarding the rate of mortality (n=4 RCTs, RR=0.87, 95% CI {0.64, 1.18}, p=0.37) and mean length of stay in NICU (n=3 RCTs, MD=-2.85 days, 95% CI {-6.52, 0.82}, p=0.13). In conclusion, among VLBW infants, the prophylactic use of oral nystatin was correlated with favorable antifungal benefits compared with placebo or no treatment intervention.

Indexed as

fungal colonizationfungal infectionlow birth weightmeta-analysisnystatin

Identifiers

PMID36168346
PMCPMC9505707

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Registered trials

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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.