Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review
Background: Most European and American countries recently updated their guidelines on Lyme borreliosis (LB). The aim of this study was to provide a comparative overview of existing guidelines on the treatment of LB in Europe and America and to assess the methodological quality of their elaboration....
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doaj-15f9573baa2746bb8aabfbb9cfc791f72021-08-26T14:11:39ZengMDPI AGPathogens2076-08172021-07-011097297210.3390/pathogens10080972Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic ReviewSteve Nguala0Elisabeth Baux1Solène Patrat-Delon2Florian Saunier3Julien Schemoul4Pierre Tattevin5Céline Cazorla6Carole Eldin7Kevin Bouiller8Alice Raffetin9Department of Infectious Diseases, Tick-Borne Diseases Reference Center, North Region, Hospital of Villeneuve–Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, FranceDepartment of Infectious Diseases, Tick-Borne Diseases Reference Center, East Region, Hospitals of Brabois—University Hospital of Nancy, Rue du Morvan, 54500 Vandoeuvre Les Nancy, FranceDepartment of Infectious Diseases and ICU, Tick-Borne Diseases Reference Center, West Region, University Hospital of Rennes Pontchaillou, CHU Rennes Pontchaillou, 2 Rue Henri Le Guilloux, 35033 Rennes, FranceDepartment of Infectious Diseases, Tick-Borne Diseases Reference Center, Central Region, University Hospital of Saint-Etienne, Avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, FranceDepartment of Rheumatology, Tick-Borne Diseases Reference Center, North Region, Hospital of Villeneuve-Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, FranceDepartment of Infectious Diseases and ICU, Tick-Borne Diseases Reference Center, West Region, University Hospital of Rennes Pontchaillou, CHU Rennes Pontchaillou, 2 Rue Henri Le Guilloux, 35033 Rennes, FranceDepartment of Infectious Diseases, Tick-Borne Diseases Reference Center, Central Region, University Hospital of Saint-Etienne, Avenue Albert-Raimond, 42270 Saint-Priest-en-Jarez, FranceTick-Borne Diseases Reference Center, South Region IHU-Méditerranée Infection, 13005 Marseille, FranceDepartment of Infectious Diseases, University Hospital of Besançon, 3 Boulevard Alexandre Fleming, 25000 Besançon, FranceDepartment of Infectious Diseases, Tick-Borne Diseases Reference Center, North Region, Hospital of Villeneuve–Saint Georges, 40 Allée de la Source, 94190 Villeneuve-Saint-Georges, FranceBackground: Most European and American countries recently updated their guidelines on Lyme borreliosis (LB). The aim of this study was to provide a comparative overview of existing guidelines on the treatment of LB in Europe and America and to assess the methodological quality of their elaboration. Methods: A systematic search was carried out in MEDLINE, Google Scholar, and the national databases of scientific societies from 2014 to 2020. Quality was assessed by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Results: Twelve guidelines were included. The scores for the AGREE II domains (median ± IQR) were: overall assessment 100 ± 22, scope and purpose 85 ± 46, stakeholder involvement 88 ± 48, rigour of development 67 ± 35, clarity of presentation 81 ± 36, applicability 73 ± 52 and editorial independence 79% ± 54%. Cohen’s weighted kappa showed a high agreement (K = 0.90, 95%CI 0.84–0.96). Guidelines were quite homogeneous regarding the recommended molecules (mostly doxycycline in the first intention and ceftriaxone in the second intention), their duration (10 to 28 days), and their dosage. The differences were due to the lack of well-conducted comparative trials. The International Lyme and Associated Diseases Society (ILADS) guidelines were the only ones to suggest longer antibiotics based on an expert consensus. Conclusion: European and American guidelines for the treatment of LB were quite homogeneous but based on moderate- to low-evidence studies. Well-conducted comparative trials are needed to assess the best molecules, the optimal duration and the most effective doses.https://www.mdpi.com/2076-0817/10/8/972Lyme borreliosistreatmentguidelinesAGREE II |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Steve Nguala Elisabeth Baux Solène Patrat-Delon Florian Saunier Julien Schemoul Pierre Tattevin Céline Cazorla Carole Eldin Kevin Bouiller Alice Raffetin |
spellingShingle |
Steve Nguala Elisabeth Baux Solène Patrat-Delon Florian Saunier Julien Schemoul Pierre Tattevin Céline Cazorla Carole Eldin Kevin Bouiller Alice Raffetin Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review Pathogens Lyme borreliosis treatment guidelines AGREE II |
author_facet |
Steve Nguala Elisabeth Baux Solène Patrat-Delon Florian Saunier Julien Schemoul Pierre Tattevin Céline Cazorla Carole Eldin Kevin Bouiller Alice Raffetin |
author_sort |
Steve Nguala |
title |
Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review |
title_short |
Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review |
title_full |
Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review |
title_fullStr |
Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review |
title_full_unstemmed |
Methodological Quality Assessment with the AGREE II Scale and a Comparison of European and American Guidelines for the Treatment of Lyme Borreliosis: A Systematic Review |
title_sort |
methodological quality assessment with the agree ii scale and a comparison of european and american guidelines for the treatment of lyme borreliosis: a systematic review |
publisher |
MDPI AG |
series |
Pathogens |
issn |
2076-0817 |
publishDate |
2021-07-01 |
description |
Background: Most European and American countries recently updated their guidelines on Lyme borreliosis (LB). The aim of this study was to provide a comparative overview of existing guidelines on the treatment of LB in Europe and America and to assess the methodological quality of their elaboration. Methods: A systematic search was carried out in MEDLINE, Google Scholar, and the national databases of scientific societies from 2014 to 2020. Quality was assessed by two independent reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. Results: Twelve guidelines were included. The scores for the AGREE II domains (median ± IQR) were: overall assessment 100 ± 22, scope and purpose 85 ± 46, stakeholder involvement 88 ± 48, rigour of development 67 ± 35, clarity of presentation 81 ± 36, applicability 73 ± 52 and editorial independence 79% ± 54%. Cohen’s weighted kappa showed a high agreement (K = 0.90, 95%CI 0.84–0.96). Guidelines were quite homogeneous regarding the recommended molecules (mostly doxycycline in the first intention and ceftriaxone in the second intention), their duration (10 to 28 days), and their dosage. The differences were due to the lack of well-conducted comparative trials. The International Lyme and Associated Diseases Society (ILADS) guidelines were the only ones to suggest longer antibiotics based on an expert consensus. Conclusion: European and American guidelines for the treatment of LB were quite homogeneous but based on moderate- to low-evidence studies. Well-conducted comparative trials are needed to assess the best molecules, the optimal duration and the most effective doses. |
topic |
Lyme borreliosis treatment guidelines AGREE II |
url |
https://www.mdpi.com/2076-0817/10/8/972 |
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