Using microbiological data to improve the use of antibiotics for respiratory tract infections: A protocol for an individual patient data meta-analysis.

Autor: Boateng I; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom., Stuart B; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.; Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom., Becque T; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom., Barrett B; Dept of Family Medicine, University of Wisconsin, Madison, WI, United States of America., Bostock J; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom., Bruyndonckx R; Data Science Institute, I-BioStat, Hasselt University, Martelarenlaan, Hasselt, Belgium., Carr-Knox L; Centre for Evaluation and Methods, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom., Ciccone EJ; Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America., Coenen S; Centre for General Practice, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium., Ebell M; Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, United States of America., Gillespie D; Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom., Hayward G; Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom., Hedin K; Futurum, Region Jönköping County, Sweden.; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden., Hood K; Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom., Lau TMM; Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, Wales, United Kingdom., Little P; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom., Merenstein D; Dept of Family Medicine, Georgetown University, Washington DC, United States of America., Mulogo E; Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda., Ordóñez-Mena J; Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom., Muir P; UK Health Security Agency South West Regional Laboratory, Southmead Hospital, Bristol, United Kingdom., Samuel K; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom., Shaikh N; School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America., Tonner S; Nuffield Department of Primary Care, University of Oxford, Oxford, United Kingdom., van der Velden AW; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands., Verheij T; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands., Wang K; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom., Hay AD; Centre for Academic Primary Care, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom., Francis N; Primary Care Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Nov 27; Vol. 18 (11), pp. e0294845. Date of Electronic Publication: 2023 Nov 27 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0294845
Abstrakt: Background: Resistance to antibiotics is rising and threatens future antibiotic effectiveness. 'Antibiotic targeting' ensures patients who may benefit from antibiotics receive them, while being safely withheld from those who may not. Point-of-care tests may assist with antibiotic targeting by allowing primary care clinicians to establish if symptomatic patients have a viral, bacterial, combined, or no infection. However, because organisms can be harmlessly carried, it is important to know if the presence of the virus/bacteria is related to the illness for which the patient is being assessed. One way to do this is to look for associations with more severe/prolonged symptoms and test results. Previous research to answer this question for acute respiratory tract infections has given conflicting results with studies has not having enough participants to provide statistical confidence.
Aim: To undertake a synthesis of IPD from both randomised controlled trials (RCTs) and observational cohort studies of respiratory tract infections (RTI) in order to investigate the prognostic value of microbiological data in addition to, or instead of, clinical symptoms and signs.
Methods: A systematic search of Cochrane Central Register of Controlled Trials, Ovid Medline and Ovid Embase will be carried out for studies of acute respiratory infection in primary care settings. The outcomes of interest are duration of disease, severity of disease, repeated consultation with new/worsening illness and complications requiring hospitalisation. Authors of eligible studies will be contacted to provide anonymised individual participant data. The data will be harmonised and aggregated. Multilevel regression analysis will be conducted to determine key outcome measures for different potential pathogens and whether these offer any additional information on prognosis beyond clinical symptoms and signs.
Trial Registration: PROSPERO Registration number: CRD42023376769.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Boateng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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