ORCID Profile
0000-0002-6521-0928
Current Organisation
Rigshospitalet
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Publisher: Wiley
Date: 28-06-2019
DOI: 10.1111/AAS.13418
Abstract: Sepsis is a relatively common and deadly condition that constitutes a major challenge to the modern health care system. Quinolones are sometimes used in combination with beta-lactam antibiotics for sepsis, but no former systematic review has assessed the benefits and harms of quinolones in patients with sepsis. We will perform a systematic review with meta-analysis and trial sequential analysis including randomised clinical trials assessing the effects of quinolones as add on therapy to usual care in children and adults with sepsis. For the assessment of harms, we will also include quasi-randomised studies and observational studies identified during our searches for randomised clinical trials. This systematic review will clarify if there is evidence to support quinolones being part of the standard treatment for sepsis.
Publisher: Elsevier BV
Date: 07-2021
DOI: 10.1016/J.JCLINEPI.2021.01.023
Abstract: To develop and validate Clinical Diversity In Meta-analyses (CDIM), a new tool for assessing clinical ersity between trials in meta-analyses of interventions. The development of CDIM was based on consensus work informed by empirical literature and expertise. We drafted the CDIM tool, refined it, and validated CDIM for interrater scale reliability and agreement in three groups. CDIM measures clinical ersity on a scale that includes four domains with 11 items overall: setting (time of conduct/country development status/units type) population (age, sex, patient inclusion criteria/baseline disease severity, comorbidities) interventions (intervention intensity/strength/duration of intervention, timing, control intervention, cointerventions) and outcome (definition of outcome, timing of outcome assessment). The CDIM is completed in two steps: first two authors independently assess clinical ersity in the four domains. Second, after agreeing upon scores of in idual items a consensus score is achieved. Interrater scale reliability and agreement ranged from moderate to almost perfect depending on the type of raters. CDIM is the first tool developed for assessing clinical ersity in meta-analyses of interventions. We found CDIM to be a reliable tool for assessing clinical ersity among trials in meta-analysis.
Publisher: Wiley
Date: 30-04-2021
DOI: 10.1111/AAS.13831
Abstract: Sepsis is common, deadly, and a major challenge to treat. Quinolones added to beta‐lactam antibiotics are currently recommended as a second‐line empiric regimen in sepsis, but the evidence regarding their benefits and harms is unclear. To assess the benefits and harms of adding quinolones to standard care for sepsis. We conducted a systematic review of randomized clinical trials with meta‐analysis and Trial Sequential Analysis. We searched CENTRAL, MEDLINE, Embase, LILACS, SCI‐Expanded, and BIOSIS. Randomized clinical trials assessing the effects of adding any quinolone to standard care for children and adults with sepsis. Two independent reviewers screened studies and extracted data. The certainty of the evidence was assessed by GRADE. We included three trials randomizing 995 adults. All trials were at overall “high risk of bias.” All trials compared a quinolone (moxifloxacin, levofloxacin, or ciprofloxacin) and a beta‐lactam antibiotic versus the same beta‐lactam antibiotic. We found no evidence of an effect of adding quinolones to beta‐lactam antibiotics when assessing all‐cause mortality (RR 1.07, 95% CI 0.86 to 1.33 2 trials 915 participants very low certainty of evidence) and serious adverse events (RR 1.00, 95% CI 0.67 to 1.50 977 participants two trials very low certainty of evidence). No trials reported on quality of life. The effects of adding quinolones to beta‐lactam antibiotics for the treatment of sepsis were unclear for all outcomes. Additional trial data are warranted to support the recommendation of empirical use of quinolones for sepsis.
No related grants have been discovered for Steven Kwasi KORANG.