There is a lack of reliable guidelines for monkeypox available around the world, experts warn today.
Although antivirals and vaccines against smallpox are available, their efficacy and optimal use is unclear, and they are not widely available, according to a report in *BMJ Global Health*.
A team led by Dr Muge Cevik of University of St Andrews, UK, looked at the availability, scope, and quality of clinical guidelines around the world.
They found 14 sets of guidelines, of which most were deemed to be low-quality, lacking detail, and covering a narrow range of topics.
Most focused on adult patients, though five included some advice for children. Only three mentioned pregnant patients, and three covered people living with HIV.
The authors state: "Treatment guidance was mostly limited to advice on antivirals. Only one guideline provided recommendations on supportive care and treatment of complications."
All of the assessed guidelines recommended vaccination as post-exposure prophylaxis, but not all of them mentioned newer generation vaccines.
The authors write: "Our results highlight a lack of evidence-based clinical management guidelines for monkeypox globally. There is a clear and urgent need for research into treatment and prophylaxis including for different risk populations."
They conclude: "The current outbreak provides an opportunity to accelerate this research through coordinated high-quality studies. New evidence should be incorporated into globally accessible guidelines, to benefit patient and epidemic outcomes.
Webb, E. et al. Availability, scope and quality of monkeypox clinical management guidelines globally: a systematic review. *BMJ Global Health* 17 August 2022; doi: 10.1136/bmjgh-2022-009838
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