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Examining the Efficacy of Antimicrobial Therapy in Preventing the Development of Postinfectious Glomerulonephritis: A Systematic Review and Meta-Analysis

Authors :
Emily Bateman
Sara Mansour
Euchariachristy Okafor
Kedzie Arrington
Bo-Young Hong
Jorge Cervantes
Source :
Infectious Disease Reports, Vol 14, Iss 2, Pp 176-183 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Postinfectious glomerulonephritis (PIGN) is an immune-mediated acute glomerulonephritis classically seen weeks after infection with Streptococcus pyogenes, although other infectious etiologies have emerged. While it has become increasingly rare in industrialized regions, it continues to affect children in developing countries. There has been debate as to why incidence rates are declining, including the possibility of improved initial treatment of bacterial infections. The ability of antimicrobial therapy in preventing PIGN as infectious sequelae, however, has not been comprehensively assessed. As varying evidence from published studies exists, the objective of this meta-analysis is to determine if antimicrobial therapy utilized to treat an initial infection has an effect in reducing the development of PIGN in humans. EMBASE, MEDLINE, and CENTRAL were searched using a comprehensive terminology strategy. From an initial search that returned 337 publications, 9 articles were included for analysis. Eight studies showed an incidence of PIGN after antimicrobial use ranging from 0.05% to 10% with a mean standardized difference (MSD) of 0.03 (0.01–0.06). Three studies showed an occurrence of PIGN without antibiotic use ranging from 1% to 13% with an MSD of 0.06 (−0.09–0.21). Our findings suggest that antimicrobial treatment for the initial infection may help diminish the development of PIGN. Although Streptococcus pyogenes infections are generally treated aggressively to prevent rheumatic fever, these findings may help further support the early treatment of bacterial infections to prevent postinfectious sequelae, especially as we consider other infectious etiologies of PIGN antimicrobial resistance.

Details

Language :
English
ISSN :
20367449
Volume :
14
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Infectious Disease Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.6b35be29f470e9117b1db0fc238fb
Document Type :
article
Full Text :
https://doi.org/10.3390/idr14020022