Evidence-based Guidelines on Medication Therapy for Neonatal Bacterial Meningitis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 HUZhi-qiang ^1,2,3,4,5 ,  ZHANGLing-li ^1,2,3,4 , LIYou-ping ⁶ , ZENGLi-nan ^1,2,3,4 , LIULi-li ^1,2,3,4,5 , CHENYuan ^1,2,3,4 , CHENMin ^1,2,3,4,5 , QUANShu-yan ^1,2,3,4,5

1. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
2. Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
3. Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu 610041, China;
4. Department of Pediatric, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
5. West China School of Pharmacy, Sichuan University, Chengdu 610041, China;
6. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

ZHANGLing-li, Email: zhlingli@sina.com

Keywords：

Neonate; Bacterial meningitis; Evidence-based guideline; Systematic review

DOI：

10.7507/1672-2531.20150008

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Objective To systematically review the quality of evidence-based guidelines (EBGs) on medication therapy for neonatal bacterial meningitis, and compare differences and similarities of the drugs recommended, in order to provide references for clinical application. Methods Databases such as the TRIP, PubMed, CNKI, VIP, WanFang, CBM, National Guideline Clearinghouse and Guidelines International Network were searched to collect evidence-based guidelines on medication therapy for neonatal bacterial meningitis. Methodological quality of included studies was assessed according to the AGREE Ⅱ instrument, and the differences and similarities among recommendations were compared. Results A total of 4 EBGs were included. Among them, one guideline was developed by the America and three guidelines were by the UK. Only one guideline was developed specially for neonates, while the rest were for neonates and children of different ages. According to the AGREE Ⅱ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation", "applicability" and "editorial independence" were scored more than 60%. The recommendations of different guidelines were basically the same, only with conflicts in some areas. Conclusion Although most guidelines concerning neonatal bacterial meningitis are of high quality, grading levels of evidence and strength of recommendation should be unified.

Citation： HUZhi-qiang, ZHANGLing-li, LIYou-ping, ZENGLi-nan, LIULi-li, CHENYuan, CHENMin, QUANShu-yan. Evidence-based Guidelines on Medication Therapy for Neonatal Bacterial Meningitis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(1): 28-35. doi: 10.7507/1672-2531.20150008 Copy

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6.	Pong A, Bradley JS. Bacterial meningitis and the newborn infant. Infect Dis Clin North Am, 1999, 13(3):711-733.
7.	de Louvois J, Halket S, Harvey D. Neonatal meningitis in England and Wales:sequelae at 5 years of age. Eur J Pediatr, 2005, 164(12):730-734.
8.	刘先知, 董柏青, 谭冬梅, 等. 南宁市新生儿细菌性脑膜炎监测研究. 新生儿科杂志, 2005, 19(5):206-209.
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16.	Scottish Intercollegiate Guidelines Network. Management of invasive meningococcal disease in children and young people. Edinburgh:SIGN. 2008.
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18.	National Institute for Health and Clinical Excellence. Antibiotics for early-onset neonatal infection. Antibiotics for the prevention and treatment of early-onset neonatal infection. London:NICE, 2012.
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20.	Vergnano S, Menson E, Kennea N, et al. Neonatal infections in England:the NeonIN surveillance network. Arch Dis Child Fetal Neonatal Ed, 2011, 96(1):F9-F14.
21.	Radetsky M. Duration of treatment in bacterial meningitis:a historical inquiry. Pediatr Infect Dis J, 1990, 9(2):2-9.
22.	O'Neill P, Heath Jr CW, Shann F, et al. Meningitis:How long to treat bacterial meningitis. Lancet, 1993, 341(8844):530.
23.	Davies EG, Elliman DAC, Hart CA, et al. Manual of Childhood Infections. London:Saunders Ltd, 2001.
24.	Daoud AS, Baticha A, Al-Sheyyab M, et al. Lack of effectiveness of dexamethasone in neonatal bacterial meningitis. Eur J Pediatr, 1999, 158(3):230-233.
25.	vande Beek D, De Gans J, McIntyre P, et al. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev, 2007, 1.
26.	张伶俐, 李幼平, 张川, 等. 中国儿童临床指南现状分析及循证临床指南评价. 中国循证医学杂志, 2011, 11(9):991-999.
27.	Canadian Task Force on the Periodic Health Examination. The periodic health examination. Can Med Assoc J, 1979, 121:1193-1254.
28.	Atkins D, Eccles M, Flottorp S. Systems for grading the quality of evidence and the strength of recommendations I:Critical appraisal of existing approaches. BMC Health Serv Res, 2004, 4(1):38.
29.	陈耀龙, 李幼平, 杜亮, 等. 医学研究中证据分级和推荐强度的演进. 中国循证医学杂志, 2008, 8(2):127-133.
30.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454):1490-1494.
31.	Kish MA. Guide to development of practice guidelines. Clin Infect Dis, 2001, 32(6):851-854.
32.	邵雪梅, 叶鸿瑁, 丘小汕. 实用新生儿学. 第4版. 北京:人民卫生出版社, 2011.
33.	Polus S, Lerberg P, Vogel J, et al. Appraisal of WHO Guidelines in Maternal Health Using the AGREE Ⅱ Assessment Tool. PloS One, 2012, 7(8):e38891.

1. 薛辛东. 儿科学. 第2版. 北京:人民卫生出版社, 2010:8.
2. Kim KS. Acute bacterial meningitis in infants and children. Lancet Infect Dis, 2010, 10(1):32-42.
3. Galiza EP, Heath PT. Improving the outcome of neonatal meningitis. Curr Opin Infect Dis, 2009, 22(3):229-234.
4. Stevens JP, Eames M, Kent A, et al. Long term outcome of neonatal meningitis. Arch Dis Child Fetal Neonatal Ed, 2003, 88(3):F179-F184.
5. Harvey D, Holt DE, Bedford H. Bacterial meningitis in the newborn:a prospective study of mortality and morbidity. Semin Perinatol, 1999, 23(8):218-225.
6. Pong A, Bradley JS. Bacterial meningitis and the newborn infant. Infect Dis Clin North Am, 1999, 13(3):711-733.
7. de Louvois J, Halket S, Harvey D. Neonatal meningitis in England and Wales:sequelae at 5 years of age. Eur J Pediatr, 2005, 164(12):730-734.
8. 刘先知, 董柏青, 谭冬梅, 等. 南宁市新生儿细菌性脑膜炎监测研究. 新生儿科杂志, 2005, 19(5):206-209.
9. Grol R. Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med Care, 2001, 39(8 Suppl 2):II46-II54.
10. Harbour R, Miller J. A new system for grading recommendations in evidence based guidelines. BMJ, 2001, 323(7308):334.
11. Lim W, Arnold DM, Bachanova V, et al. Evidence-Based Guidelines-An Introduction. ASH Education Program Book, 2008, (1):26-30.
12. Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ:advancing guideline development, reporting and evaluation in health care. CMAJ, 2010, 182(18):E839-E842.
13. AGREE Next Steps Consortium. The AGREE Ⅱ Instrument. 2009. Available at:http://www.agreetrust.org/resource-centre/agree-ii/.
14. 李春波, 何燕玲, 张明园. 一致性检验方法的合理应用. 上海精神医学, 2000, 12(4):228-230.
15. Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis, 2004, 39(9):1267-1284.
16. Scottish Intercollegiate Guidelines Network. Management of invasive meningococcal disease in children and young people. Edinburgh:SIGN. 2008.
17. National Institute for Health and Clinical Excellence. Bacterial meningitis and meningococcal septicaemia. Management of bacterial meningitis and meningococcal septicaemia in children and young people younger than 16 years in primary and secondary care. London:NICE, 2010.
18. National Institute for Health and Clinical Excellence. Antibiotics for early-onset neonatal infection. Antibiotics for the prevention and treatment of early-onset neonatal infection. London:NICE, 2012.
19. Muller-Pebody B, Johnson AP, Heath PT, et al. Empirical treatment of neonatal sepsis:are the current guidelines adequate?. Arch Dis Child Fetal Neonatal Ed, 2011, 96(1):F4-F8.
20. Vergnano S, Menson E, Kennea N, et al. Neonatal infections in England:the NeonIN surveillance network. Arch Dis Child Fetal Neonatal Ed, 2011, 96(1):F9-F14.
21. Radetsky M. Duration of treatment in bacterial meningitis:a historical inquiry. Pediatr Infect Dis J, 1990, 9(2):2-9.
22. O'Neill P, Heath Jr CW, Shann F, et al. Meningitis:How long to treat bacterial meningitis. Lancet, 1993, 341(8844):530.
23. Davies EG, Elliman DAC, Hart CA, et al. Manual of Childhood Infections. London:Saunders Ltd, 2001.
24. Daoud AS, Baticha A, Al-Sheyyab M, et al. Lack of effectiveness of dexamethasone in neonatal bacterial meningitis. Eur J Pediatr, 1999, 158(3):230-233.
25. vande Beek D, De Gans J, McIntyre P, et al. Corticosteroids for acute bacterial meningitis. Cochrane Database Syst Rev, 2007, 1.
26. 张伶俐, 李幼平, 张川, 等. 中国儿童临床指南现状分析及循证临床指南评价. 中国循证医学杂志, 2011, 11(9):991-999.
27. Canadian Task Force on the Periodic Health Examination. The periodic health examination. Can Med Assoc J, 1979, 121:1193-1254.
28. Atkins D, Eccles M, Flottorp S. Systems for grading the quality of evidence and the strength of recommendations I:Critical appraisal of existing approaches. BMC Health Serv Res, 2004, 4(1):38.
29. 陈耀龙, 李幼平, 杜亮, 等. 医学研究中证据分级和推荐强度的演进. 中国循证医学杂志, 2008, 8(2):127-133.
30. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454):1490-1494.
31. Kish MA. Guide to development of practice guidelines. Clin Infect Dis, 2001, 32(6):851-854.
32. 邵雪梅, 叶鸿瑁, 丘小汕. 实用新生儿学. 第4版. 北京:人民卫生出版社, 2011.
33. Polus S, Lerberg P, Vogel J, et al. Appraisal of WHO Guidelines in Maternal Health Using the AGREE Ⅱ Assessment Tool. PloS One, 2012, 7(8):e38891.

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