Topical antibiotics as a major contextual hazard toward bacteremia within selective digestive decontamination studies: a meta-analysis

Table 2 Logit bacteremia-IP meta-regression models ^a

Factor	Coefficient ^b	95% CI	p
Observation and control groups
Groups from observational studies (reference group)	−2 · 26	−2 · 56 - -1 · 96	<0 · 001
Non-antibiotic methods;
• Gastric study control	−0 · 28	−0 · 82 - +0 · 26	0 · 31
• Airway study control	−0 · 11	−0 · 72 - +0 · 49	0 · 71
SDD control groups;
• Non-concurrent control	+0 · 43	−0 · 12 - +0 · 98	0 · 12
• RCCT control^c	+0 · 90	+0 · 52 - +1 · 28	<0 · 001
• Control group receiving PPAP^d	−0 · 94	−1 · 54 - -0 · 34	0 · 002
CDC bacteremia criteria	−0 · 24	−0 · 54 - +0 · 07	0 · 13
Observation and intervention groups
Groups from observational studies (reference group)	−2 · 35	−2 · 64 - -2 · 07	<0 · 001
Non-antibiotic methods;
• Gastric study intervention	−0 · 32	−0 · 84 - +0 · 21	0 · 23
• Airway study intervention	−0 · 39	−0 · 97 - +0 · 18	0 · 18
SDD intervention groups;
• Non-concurrent and topical intervention alone^e	+0 · 48	−0 · 12 - +1 · 08	0 · 12
• RCCT and topical intervention alone	+0 · 97	+0 · 50 - +1 · 44	<0 · 001
• Intervention group receiving PPAP^d	−0 · 77	−1 · 24 - -0 · 29	0 · 002
CDC bacteremia criteria	−0 · 09	−0 · 38 - +0 · 21	0 · 56

^aAbbreviations; ICU, Intensive care unit; RCCT, randomized concurrent control trial; TAP, topical antibiotic prophylaxis; PPAP, protocolized parenteral antibiotic prophylaxis.
^bInterpretation. For each model the reference group is the observational study (benchmark) groups and this coefficient equals the difference in logits from 0 (a logit equal to 0 equates to a proportion of 50%; a logit equal to −2.40 equates to a proportion of 8.3%) and the other coefficients represent the difference in logits for groups positive for that factor versus the reference group.
^cSensitivity test two. Restriction of this meta-regression to component groups of studies sourced exclusively from systematic reviews yields a coefficient for control groups from SDD-RCCT’s remains positive and significantly different from zero (+0.89; +0.28 − +1.5; p = 0.005).
^dPPAP is Protocolized parenteral antibiotic prophylaxis. As indicated in Figure 1, control groups in duplex studies and three categories of SDD intervention group received PPAP.
^eSensitivity test three. Inclusion of four intervention groups from two large cluster randomized studies that used non-standard composite definitions of bacteremia in this meta-regression yields a coefficient for intervention groups from non-concurrent studies of SDD or SOD which remains positive and non-significantly different from zero (+0.40; +0.17 - +0.96; p = 0.17).

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