Do oral antibiotics prevent meningitis and serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia? A meta-analysis.
Pediatrics
; 99(3): 438-44, 1997 Mar.
Article
em En
| MEDLINE
| ID: mdl-9041302
ABSTRACT
OBJECTIVE:
To determine whether oral antibiotics prevent meningitis and serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia. DATA SOURCES Using the Medline database, the English-language literature was searched for all publications concerning bacteremia, fever, or S pneumoniae from 1966 to April 1996. STUDY SELECTION All studies that included a series of children with S pneumoniae occult bacteremia containing orally treated and untreated groups. Children were excluded from individual studies if they were immunocompromised, had a serious bacterial infection, underwent a lumbar puncture, or received parenteral antibiotics. DATA EXTRACTION Three authors independently reviewed each article to determine the number of eligible children and the outcome of children meeting entry criteria. DATASYNTHESIS:
Eleven of 21 studies were excluded, leaving 10 evaluable studies with 656 total cases of S pneumoniae occult bacteremia identified. Patients who received oral antibiotics had fewer serious bacterial infections than untreated patients (3.3% vs 9.7%; pooled odds ratio, 0.35; 95% confidence interval, 0.17 to 0.73). Meningitis developed in 3 (0.8%) of 399 children in the oral antibiotic group and 7 (2.7%) of 257 untreated children (pooled odds ratio, 0.51; 95% confidence interval, 0.12 to 2.09).CONCLUSION:
Although oral antibiotics modestly decreased the risk of serious bacterial infections in children with S pneumoniae occult bacteremia, there was insufficient evidence to conclude that oral antibiotics prevent meningitis. Published recommendations that oral antibiotics be administered to prevent serious bacterial infections in children with possible S pneumoniae occult bacteremia should be reevaluated in light of the lower risk of sequelae from S pneumoniae occult bacteremia and newer data concerning side effects from treatment.
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Base de dados:
MEDLINE
Assunto principal:
Infecções Pneumocócicas
/
Infecções Bacterianas
/
Meningites Bacterianas
/
Bacteriemia
/
Antibacterianos
Idioma:
En
Ano de publicação:
1997
Tipo de documento:
Article