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Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis

OBJECTIVE: To explore the current Chinese and English guidelines of urinary tract infection (UTI) in children and provide a summary of the recommendations of the guidelines. METHODS: An electronic search was conducted on databases, including Pubmed, SinoMed, Wangfang Data, CHKD, VIP, NICE, WHO, GIN...

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Autores principales: Zhu, Binhui, Liu, Yali, Wang, Hui, Duan, Fan, Mi, Lan, Liang, Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047976/
https://www.ncbi.nlm.nih.gov/pubmed/35477875
http://dx.doi.org/10.1136/bmjopen-2021-057736
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author Zhu, Binhui
Liu, Yali
Wang, Hui
Duan, Fan
Mi, Lan
Liang, Ying
author_facet Zhu, Binhui
Liu, Yali
Wang, Hui
Duan, Fan
Mi, Lan
Liang, Ying
author_sort Zhu, Binhui
collection PubMed
description OBJECTIVE: To explore the current Chinese and English guidelines of urinary tract infection (UTI) in children and provide a summary of the recommendations of the guidelines. METHODS: An electronic search was conducted on databases, including Pubmed, SinoMed, Wangfang Data, CHKD, VIP, NICE, WHO, GIN and Medliveto retrieve data of the clinical practice guidelines on UTI from the establishment of the database to June 2020. Four assessors assessed the quality of guidelines using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and evaluated the specific recommendations in guidelines. RESULTS: (1) Nine guidelines including two from the USA (AAP and A guideline for the inpatient care of children with pyelonephritis) and the remaining from EAU/ESPU, SINEPE, KHA-CARI, CPS, ISPN, NICE and CMA-CSP were explored. (2) The AGREE II evaluation demonstrated higher scores of UTI guidelines in terms of ‘scope and purpose’ (72.99%±11.19%) and ‘clarity of presentation’ (75.62%±7.75%), whereas the average scores were lower in the aspect of ‘stakeholder involvement’ (35.49%±14.41%), ‘rigour of development’ (37.05%±10.05%), ‘applicability’ (37.75%±11.98%) and ‘editorial independence’ (43.06%±48.14%). The average scores of the guidelines were as follows: SINePe (72.57%), CMA-CSP (62.96%), EAU/ESPU (59.61%), AAP (56.86%), NICE (47.54%), CPS (40.93%), KHA-CARI (38.86%), ISPN (38.63%) and A guideline for the inpatient care of children with pyelonephritis (34.72%). (3) All the selected guidelines basically reached a consensus on urine sample retention methods in older children, the antibiotic treatment course and renal and bladder ultrasonography application but lacked a conclusion on the determination of urine culture results, the choice of voiding cystourethrography and Tc-99mdimercaptosuccinicacid, and antibiotic prophylaxis. CONCLUSION: There remains a need to improve the quality of guidelinesfor UTI in clinical practice. Existing controversies on the current guidelines of UTI in some recommendations warrant further exploration to provide more evidence on formulating more unified and practical guidelines in the future. ETHICS AND DISSEMINATION: No ethical approval is required for this research, as it did not include patients or patient data.
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spelling pubmed-90479762022-05-11 Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis Zhu, Binhui Liu, Yali Wang, Hui Duan, Fan Mi, Lan Liang, Ying BMJ Open Paediatrics OBJECTIVE: To explore the current Chinese and English guidelines of urinary tract infection (UTI) in children and provide a summary of the recommendations of the guidelines. METHODS: An electronic search was conducted on databases, including Pubmed, SinoMed, Wangfang Data, CHKD, VIP, NICE, WHO, GIN and Medliveto retrieve data of the clinical practice guidelines on UTI from the establishment of the database to June 2020. Four assessors assessed the quality of guidelines using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and evaluated the specific recommendations in guidelines. RESULTS: (1) Nine guidelines including two from the USA (AAP and A guideline for the inpatient care of children with pyelonephritis) and the remaining from EAU/ESPU, SINEPE, KHA-CARI, CPS, ISPN, NICE and CMA-CSP were explored. (2) The AGREE II evaluation demonstrated higher scores of UTI guidelines in terms of ‘scope and purpose’ (72.99%±11.19%) and ‘clarity of presentation’ (75.62%±7.75%), whereas the average scores were lower in the aspect of ‘stakeholder involvement’ (35.49%±14.41%), ‘rigour of development’ (37.05%±10.05%), ‘applicability’ (37.75%±11.98%) and ‘editorial independence’ (43.06%±48.14%). The average scores of the guidelines were as follows: SINePe (72.57%), CMA-CSP (62.96%), EAU/ESPU (59.61%), AAP (56.86%), NICE (47.54%), CPS (40.93%), KHA-CARI (38.86%), ISPN (38.63%) and A guideline for the inpatient care of children with pyelonephritis (34.72%). (3) All the selected guidelines basically reached a consensus on urine sample retention methods in older children, the antibiotic treatment course and renal and bladder ultrasonography application but lacked a conclusion on the determination of urine culture results, the choice of voiding cystourethrography and Tc-99mdimercaptosuccinicacid, and antibiotic prophylaxis. CONCLUSION: There remains a need to improve the quality of guidelinesfor UTI in clinical practice. Existing controversies on the current guidelines of UTI in some recommendations warrant further exploration to provide more evidence on formulating more unified and practical guidelines in the future. ETHICS AND DISSEMINATION: No ethical approval is required for this research, as it did not include patients or patient data. BMJ Publishing Group 2022-04-26 /pmc/articles/PMC9047976/ /pubmed/35477875 http://dx.doi.org/10.1136/bmjopen-2021-057736 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Paediatrics
Zhu, Binhui
Liu, Yali
Wang, Hui
Duan, Fan
Mi, Lan
Liang, Ying
Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis
title Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis
title_full Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis
title_fullStr Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis
title_full_unstemmed Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis
title_short Clinical guidelines of UTIs in children: quality appraisal with AGREE II and recommendations analysis
title_sort clinical guidelines of utis in children: quality appraisal with agree ii and recommendations analysis
topic Paediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047976/
https://www.ncbi.nlm.nih.gov/pubmed/35477875
http://dx.doi.org/10.1136/bmjopen-2021-057736
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