Evidence-based Guidelines on Medication for Children with Pneumocystosis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 PANZhen-yu ¹ , LIYang ¹ , WUDong-mei ¹ , XIONGFeng-mei ¹ , LIYuan ¹ ,  CHENGHua ¹ , ZHANGLing-li ^2,3 , LIANGYi ^2,3 , LIYou-ping ⁴

1. Department of Pharmacy, Xi'an Children's Hospital, Xi'an 710003, China;
2. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
3. Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
4. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding?author：

CHENGHua, Email: chhyjk@163.com

Keywords：

Pneumocystosis; Children; Evidence-based guideline; Systematic review

DOI：

10.7507/1672-2531.20150028

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Objective To systematically review quality of evidence-based pneumocystosis guidelines for children, compare the differences and similarities among recommendations, and to provide references for clinical application. Methods Databases such as TRIP, PubMed, CNKI, VIP, WanFang Data, CBM, U.S National Guideline Clearinghouse (NGC), and Guidelines International Network (GIN) were searched to collect evidence-based guidelines on medication therapy for children with pneumocystosis. Methodological quality of included guidelines was evaluated according to the AGREE Ⅲ instrument, and the differences and similarities among recommendations were compared. Results A total of 3 evidence-based guidelines concerning children with pneumocystosis were included, of which, 2 were made by the USA and 1 by international academic organizations. Only 1 guideline was especially suitable for children, while others were for children of different ages and adults. The results of AGREE Ⅲ scoring showed that, among 6 domains which were rated using the AGREE Ⅲ instrument, "scope and purpose", "stakeholder involvement", "rigor of development", "clarity and presentation" and "editorial independence" were scored more than 60%; while "applicability" was only scored 46%, 25% and 31%. Besides, the grading of evidence and grading of recommendations were different. The medication recommendations of different guidelines were not the same. Conclusion The quality of 3 guidelines is not high, and the grading of evidence and the strength of recommendation are still needed to be unified. The target population and the recommendations in the guidelines are different.

Citation： PANZhen-yu, LIYang, WUDong-mei, XIONGFeng-mei, LIYuan, CHENGHua, ZHANGLing-li, LIANGYi, LIYou-ping. Evidence-based Guidelines on Medication for Children with Pneumocystosis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(2): 159-164. doi: 10.7507/1672-2531.20150028 Copy

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14.	李春波, 何燕玲, 張明園. 一致性檢驗方法的合理應用. 上海精神醫學, 2000, 12(4):228-230.
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1. 胡亞美, 江載芳, 主編. 諸福棠實用兒科學. 第7版. 北京:人民衛生出版社, 2010:1136-1137.
2. 吳昊, 馮鮮妮. 卡氏肺囊蟲肺炎. 中國性病艾滋病防治, 2002, 8(6):373-376.
3. Bellamy R. Pneumocystis pneumonia in people with HIV. Clin Evid, 2005, (13):854-868.
4. Peterson JC, Cushion Mr. Pneumocystis:not just pneumonia. Curt Opin Microbiol, 2005, 8(4):393-398.
5. Fishman JA. Pneumocystis jiroveci and parasitic infections in transplantation. Infect Dis Clin North Am, 1995, 9(4):1005-1044.
6. Fishman JA. Prevention of infection due to Pneumocystis carinii. Antimicrob Agents Chemother, 1998, 42(5):995-1004.
7. Fishman JA. Treatment of infection due to Pneumocystis carinii. Antimicrob Agents Chemother, 1998, 42(6):1309-1314.
8. Fishman JA. Prevention of Infection caused by Pneumocystis carinii in transplant recipients. Clin Infect Dis, 2001, 33(8):1397-1405.
9. Stratton CW. Bacterial pneumonias-an overview with emphasis on pathogenesis, diagnosis, and treatment. Heart Lung, 1986, 15(3):226-244.
10. PhairJ, MunozA, Detels R, et al. The risk of Pneumocystis carinii pneumonia among men infected with human immunodeficiency virus type 1. Multicenter AIDS Cohort Study Group. N Engl J Med, 1990, 322(3):161-165.
11. 王雪蓮, 李華軍, 安春麗. 肺孢子菌肺炎的病原學診斷及其臨床特征分析. 中國人獸共患病雜志, 2005, 21(7):633-634.
12. AGREE Next Steps Consortium. The AGREE Ⅲ Instrument. 2009. Available at:http://www.agreetrust.org/resource-centre/agree-ii/.
13. 宇文亞, 韓學杰, 張歡, 等. 基于AGREE的中醫循證臨床實踐指南質量評價研究. 世界科學技術(中醫藥現代化), 2011, 13(4):596-599.
14. 李春波, 何燕玲, 張明園. 一致性檢驗方法的合理應用. 上海精神醫學, 2000, 12(4):228-230.
15. Kidney Disease:Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. American Journal of Transplantation, 2009, 9(Suppl 3):S1-S155.
16. Centers for Disease Control and Prevention. Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIVExposed and HIV-Infected Children. MMWR, 2009, 58(RR-11):1-166.
17. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents:recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Available at:http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf.
18. 張伶俐, 李幼平, 張川, 等. 中國兒童臨床指南現狀分析及循證臨床指南評價. 中國循證醫學雜志, 2011, 11(9):991-999.
19. Wiener-Ogilvie S, Pinnock H, Huby G, et al. Do practices comply with key recommendations of the British Asthma Guideline? If not, why not? Prim Care Respir J, 2007, 16(6):369-377.
20. Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines:1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol, 2011, 64(4):383-394.

Chinese Journal of Evidence-Based Medicine

Evidence-based Guidelines on Medication for Children with Pneumocystosis: A Systematic Review

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