Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis

Abstract Background Older adults (aged 65 years and above) constitute the fastest growing population cohort in the western world. There is increasing evidence that the burden of infections disproportionately affects older adults, and hence this vulnerable population is frequently exposed to antimicr...

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Autores principales:	Tichawona Chinzowu, Sandipan Roy, Prasad S. Nishtala
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Systematic review meta-analysis Older adults Antimicrobial Organ injury Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/d00e1f6dc7b4409a88f90a7f1f37ea98
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spelling	oai:doaj.org-article:d00e1f6dc7b4409a88f90a7f1f37ea982021-11-07T12:16:55ZRisk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis10.1186/s12877-021-02512-31471-2318https://doaj.org/article/d00e1f6dc7b4409a88f90a7f1f37ea982021-11-01T00:00:00Zhttps://doi.org/10.1186/s12877-021-02512-3https://doaj.org/toc/1471-2318Abstract Background Older adults (aged 65 years and above) constitute the fastest growing population cohort in the western world. There is increasing evidence that the burden of infections disproportionately affects older adults, and hence this vulnerable population is frequently exposed to antimicrobials. There is currently no systematic review summarising the evidence for organ injury risk among older adults following antimicrobial exposure. This systematic review and meta-analysis examined the relationship between antimicrobial exposure and organ injury in older adults. Methodology We searched for original research articles in PubMed, Embase.com , Web of Science core collection, Web of Science BIOSIS citation index, Scopus, Cochrane Central Register of Controlled Trials, ProQuest, and PsycINFO databases, using key words in titles and abstracts, and using MeSH terms. We searched for all available articles up to 31 May 2021. After removing duplicates, articles were screened for inclusion into or exclusion from the study by two reviewers. The Newcastle-Ottawa scale was used to assess the risk of bias for cohort and case-control studies. We explored the heterogeneity of the included studies using the Q test and I2 test and the publication bias using the funnel plot and Egger’s test. The meta-analyses were performed using the OpenMetaAnalyst software. Results The overall absolute risks of acute kidney injury among older adults prescribed aminoglycosides, glycopeptides, and macrolides were 15.1% (95% CI: 12.8–17.3), 19.1% (95% CI: 15.4–22.7), and 0.3% (95% CI: 0.3–0.3), respectively. Only 3 studies reported antimicrobial associated drug-induced liver injury. Studies reporting on the association of organ injury and antimicrobial exposure by age or duration of treatment were too few to meta-analyse. The funnel plot and Egger’s tests did not indicate evidence of publication bias. Conclusion Older adults have a significantly higher risk of sustaining acute kidney injury when compared to the general adult population. Older adults prescribed aminoglycosides have a similar risk of acute kidney injury to the general adult population.Tichawona ChinzowuSandipan RoyPrasad S. NishtalaBMCarticleSystematic reviewmeta-analysisOlder adultsAntimicrobialOrgan injuryGeriatricsRC952-954.6ENBMC Geriatrics, Vol 21, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Systematic review meta-analysis Older adults Antimicrobial Organ injury Geriatrics RC952-954.6
spellingShingle	Systematic review meta-analysis Older adults Antimicrobial Organ injury Geriatrics RC952-954.6 Tichawona Chinzowu Sandipan Roy Prasad S. Nishtala Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis
description	Abstract Background Older adults (aged 65 years and above) constitute the fastest growing population cohort in the western world. There is increasing evidence that the burden of infections disproportionately affects older adults, and hence this vulnerable population is frequently exposed to antimicrobials. There is currently no systematic review summarising the evidence for organ injury risk among older adults following antimicrobial exposure. This systematic review and meta-analysis examined the relationship between antimicrobial exposure and organ injury in older adults. Methodology We searched for original research articles in PubMed, Embase.com , Web of Science core collection, Web of Science BIOSIS citation index, Scopus, Cochrane Central Register of Controlled Trials, ProQuest, and PsycINFO databases, using key words in titles and abstracts, and using MeSH terms. We searched for all available articles up to 31 May 2021. After removing duplicates, articles were screened for inclusion into or exclusion from the study by two reviewers. The Newcastle-Ottawa scale was used to assess the risk of bias for cohort and case-control studies. We explored the heterogeneity of the included studies using the Q test and I2 test and the publication bias using the funnel plot and Egger’s test. The meta-analyses were performed using the OpenMetaAnalyst software. Results The overall absolute risks of acute kidney injury among older adults prescribed aminoglycosides, glycopeptides, and macrolides were 15.1% (95% CI: 12.8–17.3), 19.1% (95% CI: 15.4–22.7), and 0.3% (95% CI: 0.3–0.3), respectively. Only 3 studies reported antimicrobial associated drug-induced liver injury. Studies reporting on the association of organ injury and antimicrobial exposure by age or duration of treatment were too few to meta-analyse. The funnel plot and Egger’s tests did not indicate evidence of publication bias. Conclusion Older adults have a significantly higher risk of sustaining acute kidney injury when compared to the general adult population. Older adults prescribed aminoglycosides have a similar risk of acute kidney injury to the general adult population.
format	article
author	Tichawona Chinzowu Sandipan Roy Prasad S. Nishtala
author_facet	Tichawona Chinzowu Sandipan Roy Prasad S. Nishtala
author_sort	Tichawona Chinzowu
title	Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis
title_short	Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis
title_full	Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis
title_fullStr	Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis
title_full_unstemmed	Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis
title_sort	risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d00e1f6dc7b4409a88f90a7f1f37ea98
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Risk of antimicrobial-associated organ injury among the older adults: a systematic review and meta-analysis

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