Universität zu Köln

Zheng, Feng, von Spreckelsen, Niklas ORCID: 0000-0002-9873-1711, Zhang, Xintong, Stavrinou, Pantelis ORCID: 0000-0001-8653-1395, Timmer, Marco, Dohmen, Christian, Goldbrunner, Roland, Cao, Fang, Zhang, Qiang, Ran, Qishan, Li, Gang, Fan, Ruiming, Yao, Shengtao and Krischek, Boris (2017). Should preventive antibiotics be used in patients with acute stroke? A systematic review and meta-analysis of randomized controlled trials. PLoS One, 12 (10). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Background Infection is a common complication in acute stroke. Whether or not preventive antibiotics reduce the risk of infection or even lead to a favorable outcome and reduction of mortality after a stroke still remains equivocal. This review was performed to update the current knowledge on the effect and possible benefits of prophylactic antibiotic therapy in patients with stroke. Methods A systematic review and meta-analysis of preventive antibiotics 'effect on the incidence of infection, favorable outcome (mRS <= 2) and mortality in patients with acute stroke is performed with relevant randomized controlled trials. Results Six studies were identified, involving 4125 participants. Compared with the control group, the treated groups were significantly less prone to suffer from early overall infections [RR = 0.52, 95% CI (0.39, 0.70), p<0.0001], early pneumonia [RR = 0.64, 95% CI (0.42, 0.96), p = 0.03] and early urinary tract infections [RR = 0.35, 95% CI (0.25, 0.48), p<0.00001]. However, there was no significant difference in overall mortality [RR = 1.07, 95% CI (0.90, 1.27), p = 0.44], early mortality [RR = 0.99, 95% CI (0.78, 1.26), p = 0.92], late mortality [RR = 1.12, 95% CI (0.94, 1.35), p = 0.21] or favorable outcome [RR = 1.00, 95% CI (0.92, 1.08), p = 0.98]. Conclusion Although preventive antibiotic treatment did reduce the occurrence of early overall infections, early pneumonia and early urinary tract infection in patients with acute stroke, this advantage was not eventually translated to a favorable outcome and reduction in mortality. Future studies are warranted to identify any subgroup of stroke patients who might benefit from preventive antibiotic treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zheng, Feng UNSPECIFIED UNSPECIFIED UNSPECIFIED von Spreckelsen, Niklas UNSPECIFIED orcid.org/0000-0002-9873-1711 UNSPECIFIED Zhang, Xintong UNSPECIFIED UNSPECIFIED UNSPECIFIED Stavrinou, Pantelis UNSPECIFIED orcid.org/0000-0001-8653-1395 UNSPECIFIED Timmer, Marco UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Goldbrunner, Roland UNSPECIFIED UNSPECIFIED UNSPECIFIED Cao, Fang UNSPECIFIED UNSPECIFIED UNSPECIFIED Zhang, Qiang UNSPECIFIED UNSPECIFIED UNSPECIFIED Ran, Qishan UNSPECIFIED UNSPECIFIED UNSPECIFIED Li, Gang UNSPECIFIED UNSPECIFIED UNSPECIFIED Fan, Ruiming UNSPECIFIED UNSPECIFIED UNSPECIFIED Yao, Shengtao UNSPECIFIED UNSPECIFIED UNSPECIFIED Krischek, Boris UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-214106
DOI:	10.1371/journal.pone.0186607
Journal or Publication Title:	PLoS One
Volume:	12
Number:	10
Date:	2017
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE ISCHEMIC-STROKE; MEDICAL COMPLICATIONS; RISK-FACTORS; OPEN-LABEL; INFECTION; PNEUMONIA; MINOCYCLINE; FEVER; DYSPHAGIA Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21410