دورية أكاديمية
أعرض في EDS

A Systematic Review and Meta-Analysis of the Data Behind Current Recommendations for Corticosteroids in Non-HIV-Related PCP: Knowing When You Are on Shaky Foundations.

التفاصيل البيبلوغرافية
العنوان: A Systematic Review and Meta-Analysis of the Data Behind Current Recommendations for Corticosteroids in Non-HIV-Related PCP: Knowing When You Are on Shaky Foundations.
المؤلفون: Injean P; Department of Medicine, Western University of Health Sciences, Pomona, CA., Eells SJ; Department of Epidemiology, UCLA Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA.; Science 37, Inc., Los Angeles, CA., Wu H; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA., McElroy I; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA., Gregson AL; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA., McKinnell JA; Science 37, Inc., Los Angeles, CA.; Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA.; Division of Infectious Diseases, LA-Biomed Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA.
المصدر: Transplantation direct [Transplant Direct] 2017 Feb 15; Vol. 3 (3), pp. e137. Date of Electronic Publication: 2017 Feb 15 (Print Publication: 2017).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 101651609 Publication Model: eCollection Cited Medium: Print ISSN: 2373-8731 (Print) Linking ISSN: 23738731 NLM ISO Abbreviation: Transplant Direct Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Philadelphia, Pa.] : Wolters Kluwer, [2015]-
مستخلص: Background: Randomized trials show a mortality benefit to adjunctive corticosteroids for human immunodeficiency virus (HIV)-related Pneumocystis jiroveci pneumonia (HIV-PCP). Guidelines for non-HIV PCP (NH-PCP) recommend adjunctive corticosteroids based on expert opinion. We conducted a systematic review and meta-analysis characterizing adjunctive corticosteroids for NH-PCP.
Methods: We searched MEDLINE from 1966 through 2015. Data on clinical outcomes from NH-PCP were extracted with a standardized instrument. Heterogeneity was assessed with the I 2 index. Pooled odds ratios and 95% confidence interval were calculated using a fixed effects model.
Results: Our search yielded 5044 abstracts, 277 articles were chosen for full review, and 6 articles described outcomes in moderate to severe NH-PCP. Studies were limited by variable definitions, treatment selection bias, concomitant infections and small sample size. Individual studies reported shorter intensive care unit stay and duration of mechanical ventilation of patients given adjunctive corticosteroids. There was no association between corticosteroids and survival in NH-PCP (odds ratio, 0.66; 95% confidence interval, 0.38-1.15; P = 0.14).
Conclusions: The literature does not support an association between adjunctive corticosteroids and survival from NH-PCP but data are limited and findings should not be considered conclusive. Further research with improved methodology is needed to better understand the role of adjunctive corticosteroids for NH-PCP.
Competing Interests: The authors declare no conflicts of interest.
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معلومات مُعتمدة: UL1 TR000124 United States TR NCATS NIH HHS
تواريخ الأحداث: Date Created: 20170401 Latest Revision: 20221017
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC5367754
DOI: 10.1097/TXD.0000000000000642
PMID: 28361121
قاعدة البيانات: MEDLINE
الوصف
تدمد:2373-8731
DOI:10.1097/TXD.0000000000000642