Global Management of Serious Bacterial Infections in Young Infants Aged 0 to 59 Days: An Overview of Systematic Reviews

Abstract

BACKGROUND To inform World Health Organization guidelines for the management of serious bacterial infection (SBI) (suspected or confirmed sepsis, pneumonia, or meningitis) in infants aged 0–59 days. OBJECTIVE To conduct an “overview of systematic reviews” to: (1) understand which systematic reviews have examined diagnosis and management of SBI in infants aged 0–59 days in the last 5 years; and (2) assess if the reviews examined PICOs (population, intervention, comparator, outcomes) and regimens currently being recommended in low and middle income countries (LMICs) by the World Health Organization. DATA SOURCES MEDLINE; Embase; Cochrane Library; Epistemonikos; PROSPERO. STUDY SELECTION Systematic reviews of randomized controlled trials or observational studies of infants aged 0–59 days examining diagnostic accuracy and antibiotic regimens for SBI from January 1, 2018 to November 3, 2023. DATA EXTRACTION Dual independent extraction of study characteristics, PICOs, and methodological quality. RESULTS Nine systematic reviews met our criteria. Two reviews examined diagnostic accuracy for sepsis, and no reviews examined pneumonia or meningitis. Five reviews examined antibiotic effectiveness (sepsis [n = 4]; pneumonia [n = 1]), and no reviews examined meningitis. One review examined antibiotic duration for sepsis and one for meningitis, and no reviews for pneumonia. Only 4 of the 9 systematic reviews met criteria for high-quality. LIMITATIONS Our review was limited to the last 5 years to inform current guideline updates. CONCLUSIONS Few studies have examined antibiotic regimens currently being used in LMICs and quality is of concern in many studies. More high-quality data are needed to inform management of SBI in newborns, especially in LMICs.