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European Review For Medical and... Jun 2022The current review was designed to assess the efficacy of amoxicillin (AMX) and amoxicillin-clavulanic acid (AMX-CLA) for reducing infection rates after third molar... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The current review was designed to assess the efficacy of amoxicillin (AMX) and amoxicillin-clavulanic acid (AMX-CLA) for reducing infection rates after third molar surgery.
MATERIALS AND METHODS
PubMed, Embase, ScienceDirect, and Google Scholar were searched for double-blind randomized controlled trials (RCTs) assessing the efficacy of AMX/AMX-CLA for infection control after third molar surgery.
RESULTS
13 RCTs were included. Our meta-analysis demonstrated a statistically significant reduced risk of infections with AMX/AMX-CLA (RR: 0.29, 95% CI: 0.18, 0.45 I2=0% p<0.00001). The meta-analysis demonstrated that the risk of infections was significantly reduced only in parallel-arm trials but not in split-mouth trials. Sub-group analysis based on antibiotic type indicated that the risk of infections was reduced with both AMX and AMX-CLA. A subgroup analysis based on the timing of AMX/AMX-CLA administration indicated that the risk of infections was significantly reduced with both preoperative (RR: 0.41, 95% CI: 0.21, 0.81 I2=0% p=0.01) and postoperative (RR: 0.18, 95% CI: 0.09, 0.35 I2=0% p<0.00001) administration of AMX/AMX-CLA. Meta-analysis indicated no increased risk of adverse events with the use of AMX/AMX-CLA (RR: 1.47, 95% CI: 0.41, 5.22 I2=77% p=0.55).
CONCLUSIONS
The use of AMX/AMX-CLA is associated with a significant reduction in the risk of infections after impacted third molar surgery. The risk of infections is reduced with both AMX and AMX-CLA. Our results also indicated that the infection risk was reduced with preoperative and postoperative antibiotic administration and there is no significant increase in the risk of antibiotic-related adverse events.
Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Clavulanic Acid; Molar, Third; Randomized Controlled Trials as Topic; Surgical Wound Infection
PubMed: 35731073
DOI: 10.26355/eurrev_202206_28972 -
Bosnian Journal of Basic Medical... Oct 2022This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial... (Meta-Analysis)
Meta-Analysis Review
Clinical attachment loss in the use of adjunctive antimicrobial photodynamic therapy in Stages II-IV Grade C molar-incisor periodontitis: A systematic review and meta-analysis.
This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial photodynamic therapy (aPDT) in non-surgical management of stage II-IV grade C molar-incisor pattern Periodontitis. This review protocol was conducted in accordance with PRISMA statements and is registered in PROSPERO (CRD42022321211). An electronic and manual search was conducted for relevant articles comparing the efficacy of aPDT versus scaling and root planning (SRP) alone or with amoxicillin/metronidazole (AMX/MET) published up until December 2021. The mean clinical attachment loss (CAL), probing depth (PD) reduction, and bleeding on probing (BOP) with a 95% confidence interval (CI) were pooled and compared between the two groups with CAL < and > 7 mm using a random-effect model after 3 and 6 months. To assess the heterogeneity of the findings, the I2 test was applied and Publication bias was evaluated by visual examination of the funnel plot symmetry. Analysis of 9 studies indicated a significant difference in clinical attachment gain in patients with CAL > 7 mm between the aPDT group and the SRP alone (mean difference=0.92, 95% CI=0.01-1.84, P=0.05) and SRP + AMX/MET (mean difference=0.91, 95% CI=-0.14-1.68, P=0.02) control groups. However, this difference was not significant in patients with CAL < 7 mm. Despite the limitations of the included studies, aPDT can be suggested for the improvement of clinical parameters in grade C molar-incisor pattern Periodontitis with CAL > 7 mm. However, its application in milder cases requires further investigation.
Topics: Humans; Photochemotherapy; Metronidazole; Chronic Periodontitis; Incisor; Anti-Bacterial Agents; Amoxicillin; Anti-Infective Agents
PubMed: 35656837
DOI: 10.17305/bjbms.2022.7157 -
Pathogens (Basel, Switzerland) Jul 2022Understanding the prevalence of antibiotic resistance can provide reliable information for selecting treatment options. The goal of this meta-analysis was to observe the... (Review)
Review
AIM
Understanding the prevalence of antibiotic resistance can provide reliable information for selecting treatment options. The goal of this meta-analysis was to observe the primary antibiotic resistance of () in different regions and time periods of China.
METHOD
We searched PubMed, EMBASE, Chinese Biomedical databases and the China National Knowledge Infrastructure from inception to 20 February 2022. Data on the prevalence of primary resistance at various time points were included. A random-effect model was established to calculate the pooled antibiotic resistance.
RESULTS
In total, 2150 articles were searched, with 70 meeting the inclusion criteria. The resistance to clarithromycin, metronidazole, levofloxacin amoxicillin, tetracycline and furazolidone in 2016-2020 were 34% (95% CI: 30-39%), 78% (95% CI: 73-84%), 35% (95% CI: 30-40%), 3% (95% CI: 1-5%), 2% (95%CI: 1-4%) and 1% (95% CI: 0-4%), respectively. Clarithromycin showed regional difference, as the resistance was higher in northern (37%, 95% CI: 32-41%) and western China (35%, 95% CI: 17-54%) than that in southern (24%, 95% CI: 17-32%) and eastern China (24%, 95% CI: 20-28%).
CONCLUSION
The resistance of to clarithromycin and metronidazole was high and increased over time, whereas resistance to levofloxacin, amoxicillin, tetracycline and furazolidone remained stable.
PubMed: 35890031
DOI: 10.3390/pathogens11070786 -
Journal of Global Health Feb 2023A systematic review in 2019 found reductions in antimicrobial resistance (AMR) of pneumococcal vaccine serotypes following pneumococcal conjugate vaccine (PCV)...
The impact of the introduction of ten- or thirteen-valent pneumococcal conjugate vaccines on antimicrobial-resistant pneumococcal disease and carriage: A systematic literature review.
BACKGROUND
A systematic review in 2019 found reductions in antimicrobial resistance (AMR) of pneumococcal vaccine serotypes following pneumococcal conjugate vaccine (PCV) introduction. However, few low- or middle-income countries were included as not many had introduced higher valent PCVs (PCV10 or PCV13). The aim of our review is to describe AMR rates in these samples following the introduction of PCV10 or PCV13.
METHODS
We conducted a systematic literature review of published papers that compared AMR for invasive pneumococcal disease (IPD), otitis media (OM) and nasopharyngeal carriage (NPC) samples following introduction of PCV10 or PCV13 to the pre-PCV period. Included studies published from July 2017 to August 2020 had a post-licensure observational study design and reported on our defined outcomes: IPD, OM, NPC and other (sputum or mixed invasive and non-invasive pneumococcal) isolates from people of all ages. Rates of AMR in the pre- and post-period were extracted.
RESULTS
Data were extracted from 31 studies. Among IPD isolates, penicillin AMR rates following PCV10 or PCV13 introduction declined in 32% (n = 9/29) of included studies, increased in 34% (n = 10/29) and showed no change in 34% (n = 10/29). Cephalosporins AMR declined in 32% (n = 6/19) of studies, increased in 21% (n = 4/19) and showed no change in 47% (n = 9/19). Macrolides AMR declined in 33% (n = 4/12) of studies, increased in 50% (n = 6/12), and showed no change in 17% (n = 2/12). AMR to other antibiotics (including multidrug resistance) declined in 23% (n = 9/39) of studies, increased in 41% (n = 16/39) and showed no change in AMR in 36% (n = 14/39). There were no obvious differences between AMR; in setting which used PCV10 vs PCV13, according to time since PCV introduction or by World Bank income status of the respective country. The only study including OM isolates found no change in penicillin resistance. There were few studies on AMR in NPC (four studies), OM (one study) or other isolates (five studies). The results followed similar patterns to IPD isolates.
CONCLUSIONS
We observed considerable heterogeneity in the findings between and within studies, e.g. no evidence of reduction in amoxicillin AMR with an increase in macrolides AMR. Reasons for such diverse findings include the period covered by different studies and variation in other pressures towards AMR.
Topics: Humans; Infant; Vaccines, Conjugate; Pneumococcal Infections; Streptococcus pneumoniae; Pneumococcal Vaccines; Anti-Infective Agents; Serogroup; Anti-Bacterial Agents; Otitis Media; Observational Studies as Topic
PubMed: 36799235
DOI: 10.7189/jogh.13.05001 -
National Journal of Maxillofacial... 2024To compare the effectiveness of pre-operative and post-operative administration of amoxicillin in patients undergoing third molar extraction surgery. A systematic search... (Review)
Review
To compare the effectiveness of pre-operative and post-operative administration of amoxicillin in patients undergoing third molar extraction surgery. A systematic search was executed according to PRISMA guidelines for studies published till December 2021. Studies were included based on the pre-eligibility criteria. The risk of bias was assessed using the Cochrane risk of bias tool. The heterogeneity was evaluated, and a random effect model was used for meta-analysis. A total of five studies were included from an initial search of 96 studies. The included studies were randomized controlled trials and comparative studies assessing pre-operative and post-operative administration of antibiotics among patients undergoing third molar extraction surgery. For comparison between pre-operative and post-operative groups, interincisal distance, complications, pain, and swelling were systematically reviewed and meta-analysis was done for interincisal distance and complications. The mean change in interincisal distance ranged from 5.5 to 47.9 and from 4.56 to 46.1 in the pre-operative and post-operative amoxicillin groups, respectively. Complications reported were infections, alveolar osteitis, nausea, diarrhea, gastric pain, rash, and headache with a pooled incidence of 4.3-33% in the pre-operative amoxicillin group and 0-22.7% in the post-operative amoxicillin group. Quantitative synthesis of data carried out from meta-analysis shows a significant difference in the pre-operative and post-operative amoxicillin groups in improving the interincisal distance and incidence of complications post surgery. The qualitative synthesis of data derived from systematic review for pain provides favoring results for post-operative amoxicillin administration. In case of swelling, a non-conclusive result was obtained.
PubMed: 38690250
DOI: 10.4103/njms.njms_163_22 -
The Pan African Medical Journal 2023inappropriate use of antimicrobials is a cause for concern and contributes to the global antimicrobial resistance crises especially in Africa. This review aims to... (Review)
Review
INTRODUCTION
inappropriate use of antimicrobials is a cause for concern and contributes to the global antimicrobial resistance crises especially in Africa. This review aims to summarize the available evidence on the point prevalence and pattern of antimicrobial and/or antibiotic prescription in Africa.
METHODS
this review was carried out between April and September 2021 and identified published studies up until March 2021 on the point prevalence of antibiotic and/or antimicrobial use in Africa. Sources searched were OVID, PubMed, EMBASE, CINAHL, Web of Science, Google Scholar, Google, and African Journal Online (AJOL). Observational studies that reported prevalence published in English language were included. Covidence systematic review software was used for this review. A form for data extraction using domains culled from the Global Point Prevalence Survey of Antimicrobial Consumption and Resistance (Global-PPS) was developed on Covidence. Screening of studies for eligibility was done independently by two reviewers. Critical Appraisal tool for use in Joanna Briggs Institute (JBI) Systematic Reviews for prevalence studies was used for quality appraisal.
RESULTS
a total of 17 studies that met the inclusion criteria were included in the review. The overall prevalence of antimicrobial/antibiotic use among inpatients in these studies ranged from 40.7% to 97.6%. The median antimicrobial/antibiotic use was 61.3 [IQR= 45.5-72.1]. The highest use of antimicrobials was reported among studies from Nigeria with a prevalence of 97.6%. The most prescribed antibiotics were the beta-lactam penicillin (Amoxicillin, clavulanic acid) (86.9%), and third generation cephalosporins (55.0%). There was general preference for parenteral route of administration of the antimicrobial agents (40-70%). Use for community acquired infections (28.0-79.5%) was the main reason for use. Majority of the prophylactic use of antimicrobial agents were for surgical prophylaxis. the high prevalence of antimicrobial use in Africa reinforces the need for continued surveillance and concerted efforts to institutionalize and support antimicrobial stewardship for prescribers in health institutions in the African region.
Topics: Humans; Prevalence; Anti-Infective Agents; Anti-Bacterial Agents; Nigeria; Amoxicillin
PubMed: 37637407
DOI: 10.11604/pamj.2023.45.67.36191 -
Annals of Clinical Microbiology and... Jul 2019Shigella species are a major cause of dysentery and may attribute for death worldwide. Currently antibiotic resistance became the critical challenges for management of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Shigella species are a major cause of dysentery and may attribute for death worldwide. Currently antibiotic resistance became the critical challenges for management of infectious disease. The aim was to conduct a systematic review and meta-analysis of Shigella species and its drug resistance pattern in Ethiopia.
METHODS
A comprehensive literature search was conducted through internet searches using database of MEDLINE, PubMed, Google scholar, EMBASE, HINARI, Cochrane Library and reference lists of previous prevalence studies from January 1999 to November 2018. Results were presented in forest plot, tables and figures with 95% CI. The Cochrane Q test and I test statistic were used to test heterogeneity across studies. The Pooled estimate of Shigella species and its drug resistance pattern was computed by a random effects model.
RESULTS
The pooled prevalence of Shigella species in Ethiopia was 6.6% (95% CI 4.7-8.8). In the subgroup analysis, the highest prevalence was observed among patients in Health facility (8.5%, 95% CI 6.2-11.5) whereas the lowest prevalence was observed in Community based studies (1.6%, 95% CI 0.8-3.4). In addition, Shigella species were highly resistant to ampicillin, amoxicillin, erythromycin and multi-drug resistant (MDR) with the pooled resistance proportions of 83.1% (95% CI 75.7-88.6), 84.1% (95% CI 75.6-90.1), 86.5% (95% CI 70.9-94.4) and 83.2% (95% CI 77.1-87.9), respectively. On the other hand, comparably low resistance pattern was reported for ciprofloxacin 8.9% (95% CI 6.0-12.8), ceftriaxone 9.3% (95% CI 3.9-20.5), and norfloxacin 8.2% (95% CI 3.8-16.6) and gentamycin 17.3% (95% CI 11.2-25.9). Subgroup analyses indicated that study years were associated with a decreasing Shigella prevalence over time (p = 0.002).
CONCLUSION
The pooled estimate showed high burden of Shigella infection and its high proportion of drug resistance pattern to ampicillin, amoxicillin and erythromycin in Ethiopia. Therefore, initiating and scale up of performing drug susceptibility test for each shigellosis case, educate the community and health care providers on appropriate use of antibiotics need to be considered and strengthened.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Child, Preschool; Drug Resistance, Bacterial; Dysentery, Bacillary; Ethiopia; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Prevalence; Shigella; Young Adult
PubMed: 31288806
DOI: 10.1186/s12941-019-0321-1 -
PloS One 2022Diarrhoea is the leading cause of morbidity and mortality in the world particularly in developing countries and among vulnerable groups of the population. Gram-negative... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Diarrhoea is the leading cause of morbidity and mortality in the world particularly in developing countries and among vulnerable groups of the population. Gram-negative enteric bacterial pathogens (GNEBPs) are a group of organisms that reside mainly in the intestine and induce diarrhoea. Antimicrobial agents are usually the part of their treatment regimen. The therapeutic effect of antimicrobials is hindered by the emergence and spread of drug-resistant strains. The information regarding the prevalence and antimicrobial resistance patterns of GNEBPs in Ethiopia is limited and found in a scattered form.
OBJECTIVES
This study was designed to determine the pooled prevalence and drug resistance patterns of GNEBPs by meta-analysis of data from diarrhoeic patients in Ethiopia.
METHOD
A comprehensive literature search was conducted through internet searches using Google Scholar, PubMed, Science Direct, HINARI databases, and reference lists of previous studies. Published articles were included in the study based on priorly set inclusion and exclusion criteria. Results were presented in the forest plot, tables, and figures with a 95% confidence interval (CI). The inconsistency index (I2) test statistics was used to assess heterogeneity across studies. The pooled prevalence estimate of GNEBPs and their drug resistance patterns were computed by a random-effects model. Software for Statistics and Data Science (STATA) version 14 statistical software was used for the analysis.
RESULT
After removing those articles which did not fulfil the inclusion criteria, 43 studies were included in the analysis. Studies were conducted in 8 regions of the country and most of the published articles were from the Amhara region (30.23%) followed by Oromia (18.60%) and Southern Nations, Nationalities, and Peoples' region (SNNP) (18.60%). The pooled prevalence of GNEBPs was 15.81% (CI = 13.33-18.29). The funnel plot indicated the presence of publication bias. The pooled prevalence of GNEBPs in Addis Ababa, Amhara, SNNP, and Oromia regions were 20.08, 16.67, 12.12, and 11.61%, respectively. The pooled prevalence was 14.91, 18.03, and 13.46% among studies conducted from 2006-2010, 2011-2015, and 2016-2021, respectively and it was the highest (20.35%) in children having age less than or equal to 15 years. The pooled prevalence of Escherichia coli, Campylobacter spp., Shigella spp., and Salmonella enterica were 19.79, 10.76, 6.24, and 5.06%, respectively. Large proportions (60-90%) of the isolates were resistant to ampicillin, amoxicillin, tetracycline, and trimethoprim-sulphamethoxazole. The pooled prevalence of multidrug resistance (MDR) was 70.56% (CI = 64.56-76.77%) and MDR in Campylobacter spp., Shigella spp., E. coli, and S. enterica. were 80.78, 79.08, 78.20, and 59.46%, respectively.
CONCLUSION
The pooled estimate showed a high burden of GNEBPs infections and a high proportion of drug resistance characters to commonly used antimicrobial agents in Ethiopia. Therefore, performing drug susceptibility tests, establishing an antimicrobial surveillance system and confirmation by molecular techniques are needed.
Topics: Anti-Bacterial Agents; Child; Diarrhea; Drug Resistance; Drug Resistance, Bacterial; Escherichia coli; Ethiopia; Gram-Negative Bacteria; Humans; Prevalence; Shigella
PubMed: 35294487
DOI: 10.1371/journal.pone.0265271 -
JAC-antimicrobial Resistance Jun 2024Antimicrobial resistance (AMR) is a serious threat to global health systems. is a major cause of urinary tract infections (UTIs). Understanding the AMR patterns of... (Review)
Review
BACKGROUND
Antimicrobial resistance (AMR) is a serious threat to global health systems. is a major cause of urinary tract infections (UTIs). Understanding the AMR patterns of uropathogenic (UPEC) is crucial for effective public health interventions worldwide.
OBJECTIVES
This systematic review and meta-analysis aimed to consolidate existing research and provide a comprehensive information on AMR UPEC in Ethiopia.
METHODS
We systematically searched databases such as PubMed, Web of Science, and Science Direct, along with including articles from Google Scholar. Data were extracted into Microsoft Excel and analysed using STATA 17.0. Cohen's kappa was computed to assess reviewer agreement, while the I statistic evaluated heterogeneity. Egger's tests were conducted to detect publication bias, and random-effects models were utilized to estimate the pooled resistance, with AMR rates for each antibiotic pooled separately.
RESULTS
UPEC showed resistance rates, ranging from 3.64% (95% CI: -4.38% to 11.67%) for amikacin to 85.32% (95% CI: 78.6%-92.04%) for ampicillin. Highest resistance was to ampicillin (85.32%), followed by amoxicillin at 82.52% (95% CI: 74.3%-90.74%), tetracycline at 60.67% (95% CI: 51.53%-69.81%) and trimethoprim/sulfamethoxazole at 57.17% (95% CI: 49.93%-64.42%). Conversely, resistance rates were lower for amikacin at 3.64% and meropenem at 5.26% (95% CI: 2.64%-7.88%). UPEC demonstrated a pooled MDR rate of 79.17% (95% CI: 70.32%-88.01%) and a pooled ESBL production rate of 29.16% (95% CI: 22.36%-38.55%).
CONCLUSIONS
High levels of AMR were observed in UPEC strains, highlighting a critical public health issue requiring urgent action through robust antimicrobial stewardship and surveillance to preserve effective UTI treatment options.
PubMed: 38716402
DOI: 10.1093/jacamr/dlae068 -
Clinical Infectious Diseases : An... Oct 2022Anthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Anthrax is endemic to many countries, including the United States. The causative agent, Bacillus anthracis, poses a global bioterrorism threat. Without effective antimicrobial postexposure prophylaxis (PEPAbx) and treatment, the mortality of systemic anthrax is high. To inform clinical guidelines for PEPAbx and treatment of B. anthracis infections in humans, we systematically evaluated animal anthrax treatment model studies.
METHODS
We searched for survival outcome data in 9 scientific search engines for articles describing antimicrobial PEPAbx or treatment of anthrax in animals in any language through February 2019. We performed meta-analyses of efficacy of antimicrobial PEPAbx and treatment for each drug or drug combination using random-effects models. Pharmacokinetic/pharmacodynamic relationships were developed for 5 antimicrobials with available pharmacokinetic data. Monte Carlo simulations were used to predict unbound drug exposures in humans.
RESULTS
We synthesized data from 34 peer-reviewed studies with 3262 animals. For PEPAbx and treatment of infection by susceptible B. anthracis, effective monotherapy can be accomplished with fluoroquinolones, tetracyclines, β-lactams (including penicillin, amoxicillin-clavulanate, and imipenem-cilastatin), and lipopeptides or glycopeptides. For naturally occurring strains, unbound drug exposures in humans were predicted to adequately cover the minimal inhibitory concentrations (MICs; those required to inhibit the growth of 50% or 90% of organisms [MIC50 or MIC90]) for ciprofloxacin, levofloxacin, and doxycycline for both the PEPAbx and treatment targets. Dalbavancin covered its MIC50 for PEPAbx.
CONCLUSIONS
These animal studies show many reviewed antimicrobials are good choices for PEPAbx or treatment of susceptible B. anthracis strains, and some are also promising options for combating resistant strains. Monte Carlo simulations suggest that oral ciprofloxacin, levofloxacin, and doxycycline are particularly robust choices for PEPAbx or treatment.
Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anthrax; Anti-Bacterial Agents; Anti-Infective Agents; Bacillus anthracis; Cilastatin, Imipenem Drug Combination; Ciprofloxacin; Doxycycline; Glycopeptides; Humans; Levofloxacin; Lipopeptides; Models, Animal; Tetracyclines; United States; beta-Lactams
PubMed: 36251546
DOI: 10.1093/cid/ciac591