Treatment of Childhood Brucellosis: A Systematic Review.

Autor:	Lanza Galvão E; From the Núcleo de Avaliação de Tecnologias em Saúde, Fundação Oswaldo Cruz, Belo Horizonte.; Programa de Pós-Graduação em Reabilitação e Desempenho Funcional, Departamento de Fisioterapia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina., Miranda Souza K; From the Núcleo de Avaliação de Tecnologias em Saúde, Fundação Oswaldo Cruz, Belo Horizonte., Gonçalves de Freitas M; From the Núcleo de Avaliação de Tecnologias em Saúde, Fundação Oswaldo Cruz, Belo Horizonte.; SCMED, Brazilian Health Regulatory Agency, Brasilia., Souza MRF; Programa de Pós-Graduação em Estomatopatologia da Universidade Estadual de Campinas, Piracicaba., Gonçalves MWA; Programa de Pós-Graduação em Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Cota G; From the Núcleo de Avaliação de Tecnologias em Saúde, Fundação Oswaldo Cruz, Belo Horizonte., Silva SN; From the Núcleo de Avaliação de Tecnologias em Saúde, Fundação Oswaldo Cruz, Belo Horizonte.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2024 Sep 01; Vol. 43 (9), pp. 857-866. Date of Electronic Publication: 2024 May 15.
DOI:	10.1097/INF.0000000000004389
Abstrakt:	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. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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