Antibiotic treatment for ocular toxoplasmosis: a systematic review and meta-analysis: study protocol

John E. Feliciano-Alfonso; Andrés Vargas-Villanueva; María Alejandra Marín; Laura Triviño; Natalia Carvajal; Manuela Moreno; Tatiana Luna; Clara Lopez De Mesa; Juliana Muñoz-Ortiz; Alejandra De-La-Torre

doi:10.1186/s13643-019-1067-8

Antibiotic treatment for ocular toxoplasmosis: a systematic review and meta-analysis: study protocol

John E. Feliciano-Alfonso, Andrés Vargas-Villanueva, María Alejandra Marín, Laura Triviño, Natalia Carvajal, Manuela Moreno, Tatiana Luna, Clara Lopez De Mesa, Juliana Muñoz-Ortiz, Alejandra De-La-Torre

Producción científica: Contribución a una revista › Artículo de revisión › revisión exhaustiva

10 Citas (Scopus)

Resumen

La toxoplasmosis ocular (TO) es la causa más común de uveítis posterior, lo que lleva a una discapacidad visual en una alta proporción de pacientes. Los antibióticos y los corticosteroides reducen el riesgo de discapacidad visual permanente al reducir el tamaño de la cicatriz retinocoroidea, el riesgo de recurrencia, la gravedad y duración de los síntomas agudos. Aunque la TO es una causa muy común de uveítis infecciosa posterior, su tratamiento sigue siendo controvertido. A través de nuestra revisión sistemática y metaanálisis, nuestro objetivo es proporcionar la mejor información posible basada en la evidencia sobre la seguridad y la eficacia de los diferentes regímenes de antibióticos para TO. Métodos: Este protocolo de revisión sistemática se ha desarrollado en base a las directrices PRISMA-P para informar revisiones sistemáticas que evalúan las intervenciones de atención médica. Incluiremos todos los ensayos controlados aleatorios (ECA) publicados y no publicados que comparen diferentes antibióticos utilizados para el tratamiento de TO. Consideraremos los cambios en la agudeza visual, el número de recurrencias, la mejora o el empeoramiento de la inflamación ocular, el tamaño de la lesión y los efectos adversos como nuestros resultados. La evaluación, la extracción de datos y la evaluación de la calidad serán realizadas por dos revisores con los desacuerdos resueltos mediante discusión. Se excluirán los estudios que compararon antibióticos con placebo. Las revisiones serán evaluadas por su calidad y relevancia. Evaluaremos el riesgo de sesgo en cinco dominios de acuerdo con la herramienta del grupo Cochrane. El tipo de datos determinará las medidas del efecto del tratamiento. Utilizaremos un modelo de efectos aleatorios para calcular nuestro metanálisis, ya que los estudios elegibles representan poblaciones clínicamente variadas de participantes. Discusión: la fortaleza de nuestro estudio radicará en la naturaleza exhaustiva y sistemática de la búsqueda bibliográfica, así como en sus métodos para evaluar la calidad y analizar los datos de ECA. Teniendo en cuenta la controvertida eficacia del tratamiento para OT, nuestro estudio contribuirá a mejorar la evidencia existente sobre la efectividad de diferentes antibióticos. Se pueden realizar estudios futuros para aumentar la conciencia de los médicos sobre las terapias con antibióticos, mejorando la salud de los pacientes con OT.

Idioma original	Inglés estadounidense
Número de artículo	146
Publicación	Systematic Reviews
Volumen	8
N.º	1
DOI	https://doi.org/10.1186/s13643-019-1067-8
Estado	Publicada - jun. 20 2019

Áreas temáticas de ASJC Scopus

Medicina (miscelánea)

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

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@article{aab3fb3f6f0b41cc9c9da0fc14ff7d06,

title = "Antibiotic treatment for ocular toxoplasmosis: a systematic review and meta-analysis: study protocol",

abstract = "Background: Ocular toxoplasmosis (OT) is the most common cause of posterior uveitis, leading to visual impairment in a high proportion of patients. Antibiotics and corticosteroids lower the risk of permanent visual impairment by reducing the size of the retinochoroidal scar, the risk of recurrence, and the severity and duration of acute symptoms. Although OT is a very common cause of infectious posterior uveitis, its treatment remains controversial. Through our systematic review and meta-analysis, we aim to provide the best possible evidence-based information on the safety and effectiveness of the different antibiotic regimes for OT. Methods: This systematic review protocol has been developed based on PRISMA-P guidelines for reporting systematic reviews evaluating health care interventions. We will include all published and unpublished randomized controlled trials (RCTs) comparing different antibiotics used for the treatment of OT. We will consider changes in visual acuity, number of recurrences, improvement or worsening of ocular inflammation, size of lesion, and adverse effects as our outcomes. Screening, data extraction, and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion. Studies that compared antibiotics with placebo will be excluded. The reviews will be assessed for quality and relevance. We will assess the risk of bias in five domains according to Cochrane group's tool. The type of data will dictate measures of treatment effect. We will use a random-effects model to calculate our meta-analysis, as eligible studies represent clinically varied populations of participants. Discussion: The strength of our study will lie in the exhaustive and systematic nature of the literature search, as well as in its methods for assessing quality and analyzing RCT data. Considering the controversial efficacy of the treatment for OT, our study will contribute to improving the existing evidence on the effectiveness of different antibiotics. Future studies may be conducted to increase physicians' awareness of antibiotic therapies, improving the health of patients with OT. Systematic review registration: PROSPERO CRD42018085468.",

author = "Feliciano-Alfonso, {John E.} and Andr{\'e}s Vargas-Villanueva and Mar{\'i}n, {Mar{\'i}a Alejandra} and Laura Trivi{\~n}o and Natalia Carvajal and Manuela Moreno and Tatiana Luna and {Lopez De Mesa}, Clara and Juliana Mu{\~n}oz-Ortiz and Alejandra De-La-Torre",

year = "2019",

month = jun,

day = "20",

doi = "10.1186/s13643-019-1067-8",

language = "English (US)",

volume = "8",

journal = "Systematic Reviews",

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T1 - Antibiotic treatment for ocular toxoplasmosis: a systematic review and meta-analysis: study protocol

AU - Feliciano-Alfonso, John E.

AU - Vargas-Villanueva, Andrés

AU - Marín, María Alejandra

AU - Triviño, Laura

AU - Carvajal, Natalia

AU - Moreno, Manuela

AU - Luna, Tatiana

AU - Lopez De Mesa, Clara

AU - Muñoz-Ortiz, Juliana

AU - De-La-Torre, Alejandra

PY - 2019/6/20

Y1 - 2019/6/20

N2 - Background: Ocular toxoplasmosis (OT) is the most common cause of posterior uveitis, leading to visual impairment in a high proportion of patients. Antibiotics and corticosteroids lower the risk of permanent visual impairment by reducing the size of the retinochoroidal scar, the risk of recurrence, and the severity and duration of acute symptoms. Although OT is a very common cause of infectious posterior uveitis, its treatment remains controversial. Through our systematic review and meta-analysis, we aim to provide the best possible evidence-based information on the safety and effectiveness of the different antibiotic regimes for OT. Methods: This systematic review protocol has been developed based on PRISMA-P guidelines for reporting systematic reviews evaluating health care interventions. We will include all published and unpublished randomized controlled trials (RCTs) comparing different antibiotics used for the treatment of OT. We will consider changes in visual acuity, number of recurrences, improvement or worsening of ocular inflammation, size of lesion, and adverse effects as our outcomes. Screening, data extraction, and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion. Studies that compared antibiotics with placebo will be excluded. The reviews will be assessed for quality and relevance. We will assess the risk of bias in five domains according to Cochrane group's tool. The type of data will dictate measures of treatment effect. We will use a random-effects model to calculate our meta-analysis, as eligible studies represent clinically varied populations of participants. Discussion: The strength of our study will lie in the exhaustive and systematic nature of the literature search, as well as in its methods for assessing quality and analyzing RCT data. Considering the controversial efficacy of the treatment for OT, our study will contribute to improving the existing evidence on the effectiveness of different antibiotics. Future studies may be conducted to increase physicians' awareness of antibiotic therapies, improving the health of patients with OT. Systematic review registration: PROSPERO CRD42018085468.

AB - Background: Ocular toxoplasmosis (OT) is the most common cause of posterior uveitis, leading to visual impairment in a high proportion of patients. Antibiotics and corticosteroids lower the risk of permanent visual impairment by reducing the size of the retinochoroidal scar, the risk of recurrence, and the severity and duration of acute symptoms. Although OT is a very common cause of infectious posterior uveitis, its treatment remains controversial. Through our systematic review and meta-analysis, we aim to provide the best possible evidence-based information on the safety and effectiveness of the different antibiotic regimes for OT. Methods: This systematic review protocol has been developed based on PRISMA-P guidelines for reporting systematic reviews evaluating health care interventions. We will include all published and unpublished randomized controlled trials (RCTs) comparing different antibiotics used for the treatment of OT. We will consider changes in visual acuity, number of recurrences, improvement or worsening of ocular inflammation, size of lesion, and adverse effects as our outcomes. Screening, data extraction, and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion. Studies that compared antibiotics with placebo will be excluded. The reviews will be assessed for quality and relevance. We will assess the risk of bias in five domains according to Cochrane group's tool. The type of data will dictate measures of treatment effect. We will use a random-effects model to calculate our meta-analysis, as eligible studies represent clinically varied populations of participants. Discussion: The strength of our study will lie in the exhaustive and systematic nature of the literature search, as well as in its methods for assessing quality and analyzing RCT data. Considering the controversial efficacy of the treatment for OT, our study will contribute to improving the existing evidence on the effectiveness of different antibiotics. Future studies may be conducted to increase physicians' awareness of antibiotic therapies, improving the health of patients with OT. Systematic review registration: PROSPERO CRD42018085468.

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DO - 10.1186/s13643-019-1067-8

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Antibiotic treatment for ocular toxoplasmosis: a systematic review and meta-analysis: study protocol

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