儿童布鲁氏菌病的治疗:系统回顾。

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Pediatric Infectious Disease Journal Pub Date : 2024-09-01 Epub Date: 2024-05-15 DOI:10.1097/INF.0000000000004389
Endi Lanza Galvão, Kathiaja Miranda Souza, Marina Gonçalves de Freitas, Marina Rocha Fonseca Souza, Moisés Willian Aparecido Gonçalves, Gláucia Cota, Sarah Nascimento Silva
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引用次数: 0

摘要

背景:正确治疗布鲁氏菌病对于根除感染和预防并发症至关重要,但儿科治疗的证据存在明显不足。本研究旨在通过回顾现有文献,分析儿童布鲁氏菌病治疗的有效性和安全性,并确定需要进一步调查的领域,从而填补这一空白:方法:根据系统综述和荟萃分析的首选报告项目以及 Cochrane 手册指南,对治疗儿童人类布鲁氏菌病的抗菌方案的有效性和安全性进行了系统综述。研究纳入了对 10 岁以下儿童进行药物治疗干预后取得临床结果的原始人类研究。在 Medline、Embase、Cochrane Library 和 LILACS 数据库中对 2023 年 3 月 6 日之前索引的研究进行了检索。研究筛选、数据提取和偏倚风险评估由一对审稿人共同完成。质量评估采用乔安娜-布里格斯研究所的工具和建议分级评估、发展和评价系统。数据使用 R 软件进行分析:共审查了 1773 条记录,得出 11 项符合条件的研究,涉及 1156 名儿童。所有纳入的研究均采用观察性设计。报道最多的治疗方法包括磺胺甲噁唑-三甲氧苄啶联合利福平或氨基糖苷类药物,总结的失败率分别为2%(95%置信区间:0.0-0.49)和13%(95%置信区间:0.06-0.29)(证据确定性极低)。未报告不良事件和缓解时间:结论:磺胺甲噁唑-三甲双嘧啶+利福平是儿科治疗布鲁氏菌病的最常用抗生素。这项研究强调了进行更多设计严谨的研究的必要性,并强调了抗菌方案疗效的不确定性,强调了进一步调查以指导该人群特定治疗方案的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of Childhood Brucellosis: A Systematic Review.

Background: Proper treatment for brucellosis is crucial to eradicate the infection and prevent complications, but there is a notable gap in evidence for pediatric treatment. This study aims to address this gap by reviewing current literature, analyzing the efficacy and safety of brucellosis treatment in children, and identifying areas that require further investigation.

Methods: A systematic review, following preferred reporting items for systematic reviews and meta-analyses and Cochrane Handbook guidelines, assessed antimicrobial regimens' efficacy and safety for treating human brucellosis in children. Original human studies with clinical outcomes after drug therapy intervention for children up to 10 years were included. Searches were conducted in Medline, Embase, Cochrane Library and LILACS databases for studies indexed until March 6, 2023. Study selection, data extraction, and bias risk assessment were performed by pairs of reviewers. The quality assessment used Joanna Briggs Institute tools and grading of recommendations assessment, development and evaluation system. Data were analyzed using R software.

Results: A total of 1773 records were reviewed, yielding 11 eligible studies encompassing 1156 children. All included studies presented an observational design. The most reported treatment approaches included sulfamethoxazole-trimethoprim with rifampicin or aminoglycosides, with summarized failure rates of 2% (95% confidence interval: 0.0-0.49) and 13% (95% confidence interval: 0.06-0.29), respectively (very low certainty of evidence). Adverse events and time to defervescence were not reported.

Conclusions: Sulfamethoxazole-trimethoprim + rifampicin were the most prescribed antibiotics for brucellosis for pediatrics. The study highlights the need for more research with robust designs, and emphasizes uncertainty regarding the efficacy of antimicrobial regimens, emphasizing the importance of further investigations to guide specific treatment protocols for this population.

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来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
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