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Cochrane Database of Systematic Reviews

Prophylactic systemic antifungal agents to prevent mortality and morbidity in very low birth weight infants

Overview of attention for article published in Cochrane database of systematic reviews, October 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (90th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (54th percentile)

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263 Mendeley
Title
Prophylactic systemic antifungal agents to prevent mortality and morbidity in very low birth weight infants
Published in
Cochrane database of systematic reviews, October 2015
DOI 10.1002/14651858.cd003850.pub5
Pubmed ID
Authors

Jemma Cleminson, Nicola Austin, William McGuire

Abstract

Invasive fungal infection is an important cause of mortality and morbidity in very preterm and very low birth weight infants. Early diagnosis is difficult and treatment is often delayed. Systemically absorbed antifungal agents (usually azoles) are increasingly used as prophylaxis against invasive fungal infection in this population. To assess the effect of prophylactic systemic antifungal therapy on mortality and morbidity in very preterm or very low birth weight infants. We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015, Issue 8), MEDLINE, EMBASE, and CINAHL (to May 2015), conference proceedings, and previous reviews. Randomised controlled trials or quasi-randomised controlled trials that compared the effect of prophylactic systemic antifungal therapy versus placebo or no drug or another antifungal agent or dose regimen in very low birth weight infants. We extracted data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by two review authors. We identified 15 eligible trials enrolling a total of 1690 infants. Ten trials (1371 infants) compared systemic antifungal prophylaxis versus placebo or no drug. These trials were generally of good methodological quality. Meta-analysis found a statistically significant reduction in the incidence of invasive fungal infection (typical risk ratio (RR) 0.43, 95% confidence interval (CI) 0.31 to 0.59; risk difference (RD) -0.09, 95% CI -0.12 to -0.06). The average incidence of invasive fungal infection in the control groups of the trials (16%) was much higher than that generally reported from large cohort studies. Meta-analysis did not find a statistically significant difference in the risk of death prior to hospital discharge (typical RR 0.79, 95% CI 0.61 to 1.02; typical RD -0.04, 95% CI -0.07 to 0.00). Very limited data on long-term neurodevelopmental outcomes were available. Three trials that compared systemic versus oral or topical non-absorbed antifungal prophylaxis did not detect any statistically significant effects on invasive fungal infection or mortality. Two trials that compared different dose regimens of prophylactic intravenous fluconazole did not detect any significant differences in infection rates or mortality. Prophylactic systemic antifungal therapy reduces the incidence of invasive fungal infection in very preterm or very low birth weight infants. This finding should be interpreted and applied cautiously since the incidence of invasive fungal infection was very high in the control groups of many of the included trials. Meta-analysis does not demonstrate a statistically significant effect on mortality. There are currently only limited data on the long-term neurodevelopmental consequences for infants exposed to this intervention. In addition, there is a need for further data on the effect of the intervention on the emergence of organisms with antifungal resistance.

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X Demographics

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 263 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Ethiopia 1 <1%
South Africa 1 <1%
Unknown 260 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 44 17%
Researcher 31 12%
Student > Bachelor 28 11%
Other 19 7%
Student > Ph. D. Student 16 6%
Other 44 17%
Unknown 81 31%
Readers by discipline Count As %
Medicine and Dentistry 109 41%
Nursing and Health Professions 22 8%
Pharmacology, Toxicology and Pharmaceutical Science 11 4%
Social Sciences 7 3%
Agricultural and Biological Sciences 6 2%
Other 15 6%
Unknown 93 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 April 2021.
All research outputs
#2,063,363
of 25,457,858 outputs
Outputs from Cochrane database of systematic reviews
#4,354
of 11,499 outputs
Outputs of similar age
#29,024
of 294,928 outputs
Outputs of similar age from Cochrane database of systematic reviews
#132
of 293 outputs
Altmetric has tracked 25,457,858 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,499 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 40.0. This one has gotten more attention than average, scoring higher than 64% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 294,928 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 293 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 54% of its contemporaries.