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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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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. |
format | Online Article Text |
id | pubmed-5530570 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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