Short versus long duration of antibiotic therapy for bacterial meningitis: a meta-analysis of randomised controlled trials in children. Export

@article{citeulike:5287364, abstract = {OBJECTIVE: To evaluate the effectiveness and safety of short-course antibiotic therapy for bacterial meningitis, by performing a meta-analysis of randomised controlled trials (RCT). REVIEW METHODS: PubMed and the Cochrane Central Register of Controlled Trials were searched for RCT on patients of all ages with community-acquired acute bacterial meningitis that compared treatment with the same antibiotics, in the same daily dosage, administered for a short course (up to 7 days) versus a longer course (2 days or more than corresponding short course). RESULTS: Five open-label RCT involving children (3 weeks to 16 years) were included. No difference was demonstrated between short-course (4-7 days) and long-course (7-14 days) treatment (intravenous ceftriaxone) regarding: end-of-therapy clinical success (five RCT, 383 patients, fixed effect model (FEM), odds ratio (OR) 1.24, 95\% CI 0.73 to 2.11); long-term neurological complications (five RCT, 367 patients, FEM, OR 0.60, 95\% CI 0.29 to 1.27); long-term hearing impairment (four RCT, 241 patients, FEM, OR 0.59, 95\% CI 0.28 to 1.23); total adverse events (two RCT, 122 patients, FEM, OR 1.29, 95\% CI 0.57 to 2.91); or secondary nosocomial infections (two RCT, 139 patients, random effects model, OR 0.45, 95\% CI 0.05 to 3.71). The duration of hospitalisation was lower with short-course treatment (two RCT, 137 patients, FEM, weighted mean difference -2.17 days, 95\% CI -3.85 to -0.50). The available data did not allow for analysis by causative organism. CONCLUSION: This meta-analysis of the rather limited available relevant data could not show differences between short and long-course antibiotic treatment for bacterial meningitis in children. Further research on this issue is required.}, author = {Karageorgopoulos, D. E. and Valkimadi, P. E. and Kapaskelis, A. and Rafailidis, P. I. and Falagas, M. E.}, citeulike-article-id = {5287364}, citeulike-linkout-0 = {http://dx.doi.org/10.1136/adc.2008.151563}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/19628879}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=19628879}, doi = {10.1136/adc.2008.151563}, issn = {1468-2044}, journal = {Archives of disease in childhood}, keywords = {antibiotics, meningitis}, month = {August}, number = {8}, pages = {607--614}, posted-at = {2009-07-28 07:00:57}, priority = {2}, title = {Short versus long duration of antibiotic therapy for bacterial meningitis: a meta-analysis of randomised controlled trials in children.}, url = {http://dx.doi.org/10.1136/adc.2008.151563}, volume = {94}, year = {2009} }

TY - JOUR ID - citeulike:5287364 L3 - citeulike-article-id:5287364 N2 - OBJECTIVE: To evaluate the effectiveness and safety of short-course antibiotic therapy for bacterial meningitis, by performing a meta-analysis of randomised controlled trials (RCT). REVIEW METHODS: PubMed and the Cochrane Central Register of Controlled Trials were searched for RCT on patients of all ages with community-acquired acute bacterial meningitis that compared treatment with the same antibiotics, in the same daily dosage, administered for a short course (up to 7 days) versus a longer course (2 days or more than corresponding short course). RESULTS: Five open-label RCT involving children (3 weeks to 16 years) were included. No difference was demonstrated between short-course (4-7 days) and long-course (7-14 days) treatment (intravenous ceftriaxone) regarding: end-of-therapy clinical success (five RCT, 383 patients, fixed effect model (FEM), odds ratio (OR) 1.24, 95% CI 0.73 to 2.11); long-term neurological complications (five RCT, 367 patients, FEM, OR 0.60, 95% CI 0.29 to 1.27); long-term hearing impairment (four RCT, 241 patients, FEM, OR 0.59, 95% CI 0.28 to 1.23); total adverse events (two RCT, 122 patients, FEM, OR 1.29, 95% CI 0.57 to 2.91); or secondary nosocomial infections (two RCT, 139 patients, random effects model, OR 0.45, 95% CI 0.05 to 3.71). The duration of hospitalisation was lower with short-course treatment (two RCT, 137 patients, FEM, weighted mean difference -2.17 days, 95% CI -3.85 to -0.50). The available data did not allow for analysis by causative organism. CONCLUSION: This meta-analysis of the rather limited available relevant data could not show differences between short and long-course antibiotic treatment for bacterial meningitis in children. Further research on this issue is required. IS - 8 JF - Archives of disease in childhood SN - 1468-2044 EP - 614 TI - Short versus long duration of antibiotic therapy for bacterial meningitis: a meta-analysis of randomised controlled trials in children. VL - 94 SP - 607 KW - antibiotics KW - meningitis AU - Karageorgopoulos, DE AU - Valkimadi, PE AU - Kapaskelis, A AU - Rafailidis, PI AU - Falagas, ME PY - 2009/08// UR - http://dx.doi.org/10.1136/adc.2008.151563 ER -