A systematic review and network meta-analysis were conducted to assess the relative efficacy of antimicrobial therapy for clinical mastitis in lactating dairy cattle. Controlled trials in lactating dairy cattle with natural disease exposure were eligible if they compared an antimicrobial treatment to a non-treated control, placebo, or a different antimicrobial, for the treatment of clinical mastitis, and assessed clinical or bacteriologic cure. Potential for bias was assessed using a modified Cochrane Risk of Bias 2.0 tool. From 14775 initially identified records, 54 trials were assessed as eligible. Networks were established for bacteriologic cure by bacterial species group, and clinical cure. Disparate networks among bacteriologic cures precluded meta-analysis. Network meta-analysis was conducted for trials assessing clinical cure, but lack of precision of point estimates resulted in wide credibility intervals for all treatments, with no definitive conclusions regarding relative efficacy. Consideration of network geometry can inform future research to increase the utility of current and previous work. Replication of intervention arms and consideration of connection to existing networks would improve the future ability to determine relative efficacy. Challenges in the evaluation of bias in primary research stemmed from a lack of reporting. Consideration of reporting guidelines would also improve the utility of future research.

中文翻译：

---

抗菌药物治疗泌乳奶牛临床乳腺炎的疗效比较：系统评价和网络荟萃分析

进行了系统评价和网络荟萃分析，以评估抗菌治疗对泌乳奶牛临床乳腺炎的相对疗效。如果将抗菌药物治疗与未治疗的对照、安慰剂或不同的抗菌药物进行临床乳腺炎治疗并评估临床或细菌学治愈，则在具有自然疾病暴露的泌乳奶牛中进行的对照试验是合格的。使用改进的 Cochrane Risk of Bias 2.0 工具评估潜在的偏倚。从最初确定的 14775 条记录中，有 54 项试验被评估为合格。建立了按菌种分组的细菌学治愈和临床治愈网络。细菌学治疗之间的不同网络排除了荟萃分析。对评估临床治愈率的试验进行了网络荟萃分析，但由于点估计值的精确度不足，导致所有治疗的可信区间很宽，没有关于相对疗效的明确结论。考虑网络几何可以为未来的研究提供信息，以增加当前和以前工作的效用。干预手段的复制和考虑与现有网络的连接将提高未来确定相对疗效的能力。评估初级研究中的偏见的挑战源于缺乏报告。考虑报告指南也将提高未来研究的效用。考虑网络几何可以为未来的研究提供信息，以增加当前和以前工作的效用。干预手段的复制和考虑与现有网络的连接将提高未来确定相对疗效的能力。评估初级研究中的偏见的挑战源于缺乏报告。考虑报告指南也将提高未来研究的效用。考虑网络几何可以为未来的研究提供信息，以增加当前和以前工作的效用。干预手段的复制和考虑与现有网络的连接将提高未来确定相对疗效的能力。评估初级研究中的偏见的挑战源于缺乏报告。考虑报告指南也将提高未来研究的效用。