Imperial College London
Alternate

Professor the Lord Darzi of Denham PC KBE FRS FMedSci HonFREng

Faculty of Medicine, Department of Surgery & Cancer

Co-Director of the IGHI, Professor of Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1310a.darzi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Stalteri:2021:10.1136/bmjopen-2020-046097,
author = {Stalteri, Mastrangelo R and Santesso, N and Bognanni, A and Darzi, A and Karam, S and Piggott, T and Baldeh, T and Schünemann, F and Ventresca, M and Morgano, GP and Moja, L and Loeb, M and Schunemann, H},
doi = {10.1136/bmjopen-2020-046097},
journal = {BMJ Open},
pages = {1--10},
title = {Consideration of antimicrobial resistance and contextual factors in infectious disease guidelines: a systematic survey.},
url = {http://dx.doi.org/10.1136/bmjopen-2020-046097},
volume = {11},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVES: Guidelines that include antimicrobial recommendations should explicitly consider contextual factors that influence antimicrobial resistance and their downstream effects on resistance selection. The objectives were to analyse (1) how, and to what extent, tuberculosis, gonorrhoea and respiratory tract infection guidelines are considering antimicrobial resistance; (2) are of acceptable quality and (3) if they can be easily contextualised to fit the needs of specific populations and health systems. METHODS: We conducted a systematic review and searched Ovid MEDLINE and Embase from 1 January 2007 to 7 June 2019 for tuberculosis, gonorrhoea and respiratory tract infection guidelines published in English. We also searched guideline databases, key websites and reference lists. We identified guidelines and recommendations that considered contextual factors including antimicrobial resistance, values, resource use, equity, acceptability and feasibility. We assessed quality of the guidelines using the Appraisal of Guidelines for Research and Evaluation II tool focusing on the domains scope and purpose, rigour of development, and editorial independence. RESULTS: We screened 10 365 records, of which 74 guidelines met inclusion criteria. Of these guidelines, 39% (n=29/74) met acceptable quality scores. Approximately two-thirds of recommendations considered antimicrobial resistance at the population and/or outcome level. Five of the 29 guidelines reported all factors required for recommendation contextualisation. Equity was the least considered across guidelines. DISCUSSION: Relatively few guidelines for highly prevalent infectious diseases are considering resistance at a local level, and many do not consider contextual factors necessary for appropriate antimicrobial use. Improving the quality of guidelines targeting specific regional areas is required. PROSPERO REGISTRATION NUMBER: CRD42020145235.
AU  - Stalteri,Mastrangelo R
AU  - Santesso,N
AU  - Bognanni,A
AU  - Darzi,A
AU  - Karam,S
AU  - Piggott,T
AU  - Baldeh,T
AU  - Schünemann,F
AU  - Ventresca,M
AU  - Morgano,GP
AU  - Moja,L
AU  - Loeb,M
AU  - Schunemann,H
DO  - 10.1136/bmjopen-2020-046097
EP  - 10
PY  - 2021///
SN  - 2044-6055
SP  - 1
TI  - Consideration of antimicrobial resistance and contextual factors in infectious disease guidelines: a systematic survey.
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2020-046097
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34330853
UR  - https://bmjopen.bmj.com/content/11/7/e046097
UR  - http://hdl.handle.net/10044/1/91859
VL  - 11
ER  -
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