Systemic Antibiotics for the Treatment of Neonatal Chlamydial Conjunctivitis: A Systematic Review
Bibliographic record
Abstract
Background: Chlamydia trachomatis is the most common cause of neonatal conjunctivitis 1 . Safe and effective therapies in addition to proper prophylactic strategies are needed for neonatal chlamydial conjunctivitis. Objective: To conduct a systematic review of the effects of oral erythromycin, azithromycin and trimethoprim antibiotics for the treatment of neonatal chlamydial conjunctivitis. Search Strategy : We searched Medline, Embase, and CENTRAL up to May 10 th 2015, did not restrict by language or study type and reviewed reference lists of relevant studies, guidelines, and systematic reviews. Selection Criteria : Randomised controlled trials or non-randomised studies that assessed the effects of treatment of neonatal chlamydial conjunctivitis using erythromycin, azithromycin or trimethoprim antibiotics. Data Collection & Analysi s: Two independent investigators collected, extracted and analyzed data. Risk of bias and quality of evidence according to GRADE were determined. Results: We included a total of 9 studies of (2 randomised & 7 non-randomised). Quality of evidence as a result of publication bias and imprecision was either low or very low. Combined event rates for clinical and microbiological cure using the most common treatment dosage, erythromycin 50 mg/kg per day for 14 days, was 125/130 (96.2%). Azithromycin clinical and microbiological cure rate was 60% for a 20mg/kg per day as a single dose and 85.7% for 20 mg/kg/d for 3 days. The most frequent complication was nasopharyngeal co-infection observed in about 22.7% to 57.6% of cases depending on the dosage. Side effects included gastrointestinal disturbances with a range of 7.1% to 42.9% depending on the dosage regimen. None of the studies found assessed trimethoprim. Conclusions: We provide a comprehensive summary of the efficacy, complications and side effects of current treatments for neonatal conjunctivitis.However, more research is needed using higher quality randomised controlled trials in order to better assess current treatment practices and test newer antibiotics that may have easier dosage regimens and less side effects.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".