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Empiric treatment against invasive fungal diseases in febrile neutropenic patients: a systematic review and network meta-analysis

Overview of attention for article published in BMC Infectious Diseases, February 2017
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Title
Empiric treatment against invasive fungal diseases in febrile neutropenic patients: a systematic review and network meta-analysis
Published in
BMC Infectious Diseases, February 2017
DOI 10.1186/s12879-017-2263-6
Pubmed ID
Authors

Ken Chen, Qi Wang, Roy A. Pleasants, Long Ge, Wei Liu, Kangning Peng, Suodi Zhai

Abstract

The most optimal antifungal agent for empiric treatment of invasive fungal diseases (IFDs) in febrile neutropenia is controversial. Our objective was evaluate the relative efficacy of antifungals for all-cause mortality, fungal infection-related mortality and treatment response in this population. Pubmed, Embase and Cochrane Library were searched to identify randomized controlled trials (RCTs). Two reviewers performed the quality assessment and extracted data independently. Pairwise meta-analysis and network meta-analysis were conducted to compare the antifungals. Seventeen RCTs involving 4583 patients were included. Risk of bias of included studies was moderate. Pairwise meta-analysis indicated the treatment response rate of itraconazole was significantly better than conventional amphotericin B (RR = 1.33, 95%CI 1.10-1.61). Network meta-analysis showed that amphotericin B lipid complex, conventional amphotericin B, liposomal amphotericin B, itraconazole and voriconazole had a significantly lower rate of fungal infection-related mortality than no antifungal treatment. Other differences in outcomes among antifungals were not statistically significant. From the rank probability plot, caspofungin appeared to be the most effective agent for all-cause mortality and fungal infection-related mortality, whereas micafungin tended to be superior for treatment response. The results were stable after excluding RCTs with high risk of bias, whereas micafungin had the lowest fungal infection-related mortality. Our results highlighted the necessity of empiric antifungal treatment and indicates that echinocandins appeared to be the most effective agents for empiric treatment of febrile neutropenic patients based on mortality and treatment response. However, more studies are needed to determine the best antifungal agent for empiric treatment. Our systematic review has been prospectively registered in PROSPERO and the registration number was CRD42015026629.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 75 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 75 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 16%
Student > Master 9 12%
Student > Doctoral Student 8 11%
Other 8 11%
Student > Bachelor 8 11%
Other 12 16%
Unknown 18 24%
Readers by discipline Count As %
Medicine and Dentistry 34 45%
Pharmacology, Toxicology and Pharmaceutical Science 7 9%
Agricultural and Biological Sciences 4 5%
Immunology and Microbiology 3 4%
Nursing and Health Professions 3 4%
Other 8 11%
Unknown 16 21%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 October 2018.
All research outputs
#17,879,732
of 22,955,959 outputs
Outputs from BMC Infectious Diseases
#5,149
of 7,706 outputs
Outputs of similar age
#224,025
of 310,289 outputs
Outputs of similar age from BMC Infectious Diseases
#118
of 166 outputs
Altmetric has tracked 22,955,959 research outputs across all sources so far. This one is in the 19th percentile – i.e., 19% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,706 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.6. This one is in the 26th percentile – i.e., 26% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 310,289 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 23rd percentile – i.e., 23% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 166 others from the same source and published within six weeks on either side of this one. This one is in the 26th percentile – i.e., 26% of its contemporaries scored the same or lower than it.