SynthesisJournal of global health2024
Antibiotics for acute watery or persistent with or without bloody diarrhoea in children: A systematic review and meta-analysis.
Synthesis in Journal of global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
Background: The use of antibiotics in the treatment of acute and persistent watery diarrhoea has long been a subject of contention. While the advantages of using antimicrobials are acknowledged, concerns remain regarding potential adverse effects and antibiotic resistance. Therefore, we conducted a systematic review and meta-analysis to assess the efficacy of antibiotics compared to placebos for the treatment of diarrhoea. Methods: We searched PubMed, CINAHL, the Cochrane Library, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform, and Scopus from inception until 20 July 2023 for studies published after the year 2000 assessing antibiotics vs placebo in acute and persistent diarrhoea and/or blood in stools in children less than 10 years of age. We conducted a meta-analysis for the included studies, assessed them using the Risk of Bias 2 tool, and evaluated their quality of evidence through the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. This review was commissioned by WHO for revision of their guidelines for childhood diarrhoea management. Results: We included five randomised controlled trials (RCTs) for acute watery diarrhoea and no study for bloody diarrhoea. Our findings suggest that there is a significant increase in clinical cure (risk ratio (RR) = 2.28; 95% confidence interval (CI) = 1.52, 3.41; low certainty evidence) and parasitological cure (RR = 2.86; 95% CI = 1.72 to 4.74; low certainty evidence) among children with acute watery diarrhoea in the antibiotic group when compared to the placebo group. The duration of diarrhoea (in hours) was significantly reduced (mean difference = -24.90; 95% CI = -34.09, -15.71; low certainty evidence) in the intervention group, while the effect on all-cause mortality (RR = 0.71; 95% CI = 0.40, 1.27; moderate certainty evidence) and the need for intravenous fluid infusion (RR = 0.50; 95% CI = 0.05, 5.17; very low certainty evidence) were comparable between the two groups. Conclusions: In children under 10 years of age suffering from acute watery or persistent diarrhoea, antibiotics led to an apparent increase in cure rates. However, considering the low certainty of evidence, low number of studies with small sample sizes, and the fact that most studies were conducted in a single country, further investigation and cautious interpretation are warranted, as is a large multi-country RCT that would allow for firmer conclusions. Registration: PROSPERO: CRD42023447133.
Indexed as
Identifiers
What OpenQuestion holds
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.