Meta-Analysis
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Aug 26, 2016; 4(4): 77-87
Published online Aug 26, 2016. doi: 10.13105/wjma.v4.i4.77
Antibiotics for eradicating meningococcal carriages: Network meta-analysis and investigation of evidence inconsistency
Asmaa S Abdelhamid, Yoon K Loke, Ibrahim Abubakar, Fujian Song
Asmaa S Abdelhamid, Yoon K Loke, Fujian Song, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, United Kingdom
Ibrahim Abubakar, Institute of Epidemiology and Health, University College of London, London WC1E 6BT, United Kingdom
Author contributions: Song F had the initial idea; Abdelhamid AS and Song F extracted data from the included trials; Song F conducted data analyses; Abdelhamid AS, Loke YK and Song F investigated causes of inconsistencies, and drafted the manuscript; Abubakar I provided clinical advice on the interpretation of results and critically commented on the manuscript; all authors approved the manuscript.
Supported by Partly the UK Medical Research Council, No. G0701607.
Conflict-of-interest statement: All authors declare no conflict of interest. The study design, data collection and interpretation have not been influenced by the funder.
Data sharing statement: All available data has been presented in the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fujian Song, PhD, Professor, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, United Kingdom. fujian.song@uea.ac.uk
Telephone: +44-1603-591253 Fax: +44-1603-59752
Received: April 25, 2016
Peer-review started: April 26, 2016
First decision: June 16, 2016
Revised: June 28, 2016
Accepted: July 14, 2016
Article in press: July 18, 2016
Published online: August 26, 2016
Core Tip

Core tip: This network meta-analysis found that a range of prophylactic antibiotic regimens are effective for eradicating meningococcal carriages. A combination of rifampin and minocycline seems the most efficacious, and ceftriaxone is also likely to be more effective than ciprofloxacin or rifampin alone. Careful investigation of significant inconsistency between direct and indirect comparison of rifampin and ciprofloxacin found that it was mainly caused by different types of carriers (persistent or any) and the varying doses of ciprofloxacin in the included trials. Detailed examination of characteristics of relevant studies should be conducted for investigating causes of inconsistency in network meta-analysis.