Untargeted antifungal therapy in adult patients with complicated intra-abdominal infection: A systematic review

M. W. Petersen, A. Perner, F. Ravn, F. Sjövall, M. H. Møller

Research output: Contribution to journalArticlepeer-review

2 Citations (SciVal)

Abstract

Background: Systematic reviews comparing untargeted antifungal treatment with placebo or no treatment in critically ill patients have provided conflicting results. We aimed to assess patient-important benefits and harms of untargeted antifungal therapy vs. placebo or no treatment in adult patients with complicated intra-abdominal infection. Methods: We conducted a systematic review with meta-analysis and trial sequential analysis of randomised clinical trials assessing untargeted antifungal therapy compared to placebo or no treatment in adults with complicated intra-abdominal infection. We used the Cochrane and GRADE methodologies and exclusively assessed patient-important outcomes. Two independent authors screened trials for eligibility, extracted data and assessed risk of bias. We performed conventional meta-analyses, including sensitivity and subgroup analyses, and trial sequential analysis to assess the risk of random errors and to estimate trial sequential analysis adjusted confidence intervals. Results: We included six trials (1,067 patients) in the review, and four trials reported data on the predefined outcome measures and were included in the meta-analysis. Three of the four trials had high risk of bias. We observed no statistically significant difference in mortality (relative risk 0.58, 95% confidence interval 0.24-1.39) or in any of the other patient-important outcomes between untargeted antifungal treatment and placebo or no treatment (low/very low quality of evidence). Trial sequential analysis demonstrated lack of data and high risk of random errors. Conclusions: The quantity and quality of evidence supporting untargeted antifungal treatment in adult patients with complicated intra-abdominal infection are low to very low with no firm evidence for benefit or harm.

Original languageEnglish
Pages (from-to)6-18
JournalActa Anaesthesiologica Scandinavica
Volume62
Issue number1
Early online date2017
DOIs
Publication statusPublished - 2018 Jan

Subject classification (UKÄ)

  • Anesthesiology and Intensive Care

Fingerprint

Dive into the research topics of 'Untargeted antifungal therapy in adult patients with complicated intra-abdominal infection: A systematic review'. Together they form a unique fingerprint.

Cite this