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Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review

BACKGROUND: Adverse events from intrapartum antibiotic prophylaxis (IAP) are poorly documented yet essential to inform clinical practice for neonatal group B Streptococcus (GBS) disease prevention. In this systematic review, we appraised and synthesised the evidence on the adverse events of IAP in t...

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Autores principales: Seedat, Farah, Stinton, Chris, Patterson, Jacoby, Geppert, Julia, Tan, Bee, Robinson, Esther R., McCarthy, Noel Denis, Uthman, Olalekan A., Freeman, Karoline, Johnson, Samantha Ann, Fraser, Hannah, Brown, Colin Stewart, Clarke, Aileen, Taylor-Phillips, Sian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530570/
https://www.ncbi.nlm.nih.gov/pubmed/28747160
http://dx.doi.org/10.1186/s12884-017-1432-3
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author Seedat, Farah
Stinton, Chris
Patterson, Jacoby
Geppert, Julia
Tan, Bee
Robinson, Esther R.
McCarthy, Noel Denis
Uthman, Olalekan A.
Freeman, Karoline
Johnson, Samantha Ann
Fraser, Hannah
Brown, Colin Stewart
Clarke, Aileen
Taylor-Phillips, Sian
author_facet Seedat, Farah
Stinton, Chris
Patterson, Jacoby
Geppert, Julia
Tan, Bee
Robinson, Esther R.
McCarthy, Noel Denis
Uthman, Olalekan A.
Freeman, Karoline
Johnson, Samantha Ann
Fraser, Hannah
Brown, Colin Stewart
Clarke, Aileen
Taylor-Phillips, Sian
author_sort Seedat, Farah
collection PubMed
description BACKGROUND: Adverse events from intrapartum antibiotic prophylaxis (IAP) are poorly documented yet essential to inform clinical practice for neonatal group B Streptococcus (GBS) disease prevention. In this systematic review, we appraised and synthesised the evidence on the adverse events of IAP in the mother and/or her child. METHODS: We searched MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Cochrane, and Science Citation Index from date of inception until October 16th 2016. Reference lists of included studies and relevant systematic reviews were hand-searched. We included primary studies in English that reported any adverse events from intrapartum antibiotics for any prophylactic purpose compared to controls. The search was not restricted to prophylaxis for GBS but excluded women with symptoms of infection or undergoing caesarean section. Two reviewers assessed the methodological quality of studies, using the Cochrane Risk of Bias tool, and the Risk of Bias Assessment Tool for Nonrandomised Studies. Results were synthesised narratively and displayed in text and tables. RESULTS: From 2364 unique records, 30 studies were included. Despite a wide range of adverse events reported in 17 observational studies and 13 randomised controlled trials (RCTs), the evidence was inconsistent and at high risk of bias. Only one RCT investigated the long-term effects of IAP reporting potentially serious outcomes such as cerebral palsy; however, it had limited applicability and unclear biological plausibility. Seven observational studies showed that IAP for maternal GBS colonisation alters the infant microbiome. However, study populations were not followed through to clinical outcomes, therefore clinical significance is unknown. There was also observational evidence for increased antimicrobial resistance, however studies were at high or unclear risk of bias. CONCLUSIONS: The evidence base to determine the frequency of adverse events from intrapartum antibiotic prophylaxis for neonatal GBS disease prevention is limited. As RCTs may not be possible, large, better quality, and longitudinal observational studies across countries with widespread IAP could fill this gap. TRIAL REGISTRATION: CRD42016037195. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-017-1432-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-55305702017-08-02 Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review Seedat, Farah Stinton, Chris Patterson, Jacoby Geppert, Julia Tan, Bee Robinson, Esther R. McCarthy, Noel Denis Uthman, Olalekan A. Freeman, Karoline Johnson, Samantha Ann Fraser, Hannah Brown, Colin Stewart Clarke, Aileen Taylor-Phillips, Sian BMC Pregnancy Childbirth Research Article BACKGROUND: Adverse events from intrapartum antibiotic prophylaxis (IAP) are poorly documented yet essential to inform clinical practice for neonatal group B Streptococcus (GBS) disease prevention. In this systematic review, we appraised and synthesised the evidence on the adverse events of IAP in the mother and/or her child. METHODS: We searched MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Cochrane, and Science Citation Index from date of inception until October 16th 2016. Reference lists of included studies and relevant systematic reviews were hand-searched. We included primary studies in English that reported any adverse events from intrapartum antibiotics for any prophylactic purpose compared to controls. The search was not restricted to prophylaxis for GBS but excluded women with symptoms of infection or undergoing caesarean section. Two reviewers assessed the methodological quality of studies, using the Cochrane Risk of Bias tool, and the Risk of Bias Assessment Tool for Nonrandomised Studies. Results were synthesised narratively and displayed in text and tables. RESULTS: From 2364 unique records, 30 studies were included. Despite a wide range of adverse events reported in 17 observational studies and 13 randomised controlled trials (RCTs), the evidence was inconsistent and at high risk of bias. Only one RCT investigated the long-term effects of IAP reporting potentially serious outcomes such as cerebral palsy; however, it had limited applicability and unclear biological plausibility. Seven observational studies showed that IAP for maternal GBS colonisation alters the infant microbiome. However, study populations were not followed through to clinical outcomes, therefore clinical significance is unknown. There was also observational evidence for increased antimicrobial resistance, however studies were at high or unclear risk of bias. CONCLUSIONS: The evidence base to determine the frequency of adverse events from intrapartum antibiotic prophylaxis for neonatal GBS disease prevention is limited. As RCTs may not be possible, large, better quality, and longitudinal observational studies across countries with widespread IAP could fill this gap. TRIAL REGISTRATION: CRD42016037195. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-017-1432-3) contains supplementary material, which is available to authorized users. BioMed Central 2017-07-26 /pmc/articles/PMC5530570/ /pubmed/28747160 http://dx.doi.org/10.1186/s12884-017-1432-3 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Seedat, Farah
Stinton, Chris
Patterson, Jacoby
Geppert, Julia
Tan, Bee
Robinson, Esther R.
McCarthy, Noel Denis
Uthman, Olalekan A.
Freeman, Karoline
Johnson, Samantha Ann
Fraser, Hannah
Brown, Colin Stewart
Clarke, Aileen
Taylor-Phillips, Sian
Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review
title Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review
title_full Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review
title_fullStr Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review
title_full_unstemmed Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review
title_short Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review
title_sort adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530570/
https://www.ncbi.nlm.nih.gov/pubmed/28747160
http://dx.doi.org/10.1186/s12884-017-1432-3
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