Oral Antibiotic Therapy for Treating Infective Endocarditis
Oral Antibiotic Therapy for Treating Infective Endocarditis
Our review protocol conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Our systematic search strategy was developed to capture all articles of IE in which oral antibiotic therapy was used. We included articles reporting in English, French, Spanish and Arabic languages. We searched the following databases: MEDLINE (from 1948 to June 1, 2013), EMBASE (from 1947 to June 1, 2013), and Scopus (from 1960 to June 1, 2013). Reference lists of selected papers were also screened for additional articles of interest. The search strategies used are presented in Additional file 1.
We only included studies of IE in which the duration of antibiotic treatment was >2 weeks and oral antibiotics where the only antibiotics given after 2 weeks of treatment initiation. To be eligible, studies had to a) report mortality and clinical cure as their outcomes of interest; b) report the microbiology of their IE cases; and c) present their data in a way that it allowed for the calculation of outcome rates as a function of the entire study cohort. Studies with focus on culture negative endocarditis were excluded. We also excluded case series (defined as studies with <10 participants) and articles without original data.
All titles and abstracts of the citations identified by our literature search were independently screened by two investigators (AA-O and VFC-M). Relevant articles were reviewed in their entirety. Each investigator made a recommendation for inclusion or exclusion of single articles and if discordant, a third investigator solved the discrepancy (CL). When 2 or more articles had overlap of their populations and reported on the same outcomes, only the most inclusive article was considered.
Using a standardized form, we systematically collected data on the outcomes of interest, the characteristics of the populations studied, whether IE involved the right or left heart valves, and several aspects of the study setting and methodological design. For purposes of this review, cure was defined as both microbiological and clinical resolution of the infection. We used the McMaster University literature appraisal recommendations to evaluate the quality of observational studies; whereas for clinical trials, we used the Consolidated Standards of Reporting Trials (CONSORT) guidelines. We made every effort to calculate pooled incidence rates for the outcomes of interest when feasible.
Methods
Our review protocol conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Search Strategy
Our systematic search strategy was developed to capture all articles of IE in which oral antibiotic therapy was used. We included articles reporting in English, French, Spanish and Arabic languages. We searched the following databases: MEDLINE (from 1948 to June 1, 2013), EMBASE (from 1947 to June 1, 2013), and Scopus (from 1960 to June 1, 2013). Reference lists of selected papers were also screened for additional articles of interest. The search strategies used are presented in Additional file 1.
Eligibility Criteria
We only included studies of IE in which the duration of antibiotic treatment was >2 weeks and oral antibiotics where the only antibiotics given after 2 weeks of treatment initiation. To be eligible, studies had to a) report mortality and clinical cure as their outcomes of interest; b) report the microbiology of their IE cases; and c) present their data in a way that it allowed for the calculation of outcome rates as a function of the entire study cohort. Studies with focus on culture negative endocarditis were excluded. We also excluded case series (defined as studies with <10 participants) and articles without original data.
Selection of Studies
All titles and abstracts of the citations identified by our literature search were independently screened by two investigators (AA-O and VFC-M). Relevant articles were reviewed in their entirety. Each investigator made a recommendation for inclusion or exclusion of single articles and if discordant, a third investigator solved the discrepancy (CL). When 2 or more articles had overlap of their populations and reported on the same outcomes, only the most inclusive article was considered.
Data Extraction, Synthesis and Analyses
Using a standardized form, we systematically collected data on the outcomes of interest, the characteristics of the populations studied, whether IE involved the right or left heart valves, and several aspects of the study setting and methodological design. For purposes of this review, cure was defined as both microbiological and clinical resolution of the infection. We used the McMaster University literature appraisal recommendations to evaluate the quality of observational studies; whereas for clinical trials, we used the Consolidated Standards of Reporting Trials (CONSORT) guidelines. We made every effort to calculate pooled incidence rates for the outcomes of interest when feasible.
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