| Quality assessment | Summary of findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No of patients | Effect | Quality | |||||||||
| No of studies | Design | Limitations | Inconsistency | Indirectness | Imprecision | Other considerations | IV-to-oral antibiotics at any time | IV antibiotics | Relative (95% CI) | Absolute | |
| Death | |||||||||||
| 6 | randomised trials | serious1 | no serious inconsistency | no serious indirectness | very serious2 | none | 11/442 (2.5%) | 8/422 (1.9%) | RR 1.14 (0.48 to 2.73) | 3 more per 1000 (from 10 fewer to 33 more) | VERY LOW |
| Treatment failure (composite measure3) | |||||||||||
| 6 | randomised trials | serious1 | no serious inconsistency | no serious indirectness | Serious4 | none | 158/482 (32.8%) | 137/464 (29.5%) | RR 1.07 (0.9 to 1.27) | 21 more per 1000 (from 30 fewer to 80 more) | LOW |
Two of the trials observed a number of deaths whereas no deaths were observed in the remaining 4 trials.
The number of events was very low, with no events observed in 4/6 trials. This clearly suggests that the trials were not powered to detect this outcome.
Treatment failure defined as a composite end-point comprising one or more of the following: death; persistence, recurrence or worsening of clinical signs or symptoms of presenting infection; any addition to or modification of the assigned intervention.
Relatively low number of events.
| Quality assessment | Summary of findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No of patients | Effect | Quality | |||||||||
| No of studies | Design | Limitations | Inconsistency | Indirectness | Imprecision | Other considerations | IV-to-oral antibiotics after 72 hours of IV antibiotics and response to IV antibiotics | IV antibiotics | Relative (95% CI) | Absolute | |
| Death | |||||||||||
| 2 | randomised trials | serious1 | no serious inconsistency | no serious indirectness | very serious2 | none | 11/173 (6.4%) | 8/152 (5.3%) | RR 1.14 (0.48 to 2.73) | 7 more per 1000 (from 27 fewer to 91 more) | VERY LOW |
| Treatment failure (Composite outcome3) | |||||||||||
| 2 | randomised trials | serious1 | no serious inconsistency | no serious indirectness | Serious4 | none | 98/180 (54.4%) | 87/162 (53.7%) | RR 1.01 (0.83 to 1.23) | 5 more per 1000 (from 91 fewer to 124 more) | LOW |
The designs of the included trials were both compromised either by providing no information about the method of randomisation and about whether allocation concealment or blinding was used or by not using intention to treat analysis.
The number of events was very low. This clearly suggests that the trials were not powered to detect this outcome.
Treatment failure defined as a composite end-point comprising one or more of the following: death; persistence, recurrence or worsening of clinical signs or symptoms of presenting infection; any addition to or modification of the assigned intervention.
The number of events was < 300
| Quality assessment | Summary of findings | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No of patients | Effect | Quality | |||||||||
| No of studies | Design | Limitations | Inconsistency | Indirectness | Imprecision | Other considerations | IV-to-oral antibiotics after 48-72 hours of IV antibiotics | IV antibiotics | Relative (95% CI) | Absolute | |
| Death | |||||||||||
| 2 | randomised trials | serious1 | no serious inconsistency | no serious indirectness | very serious2 | none | 0/174 (0%) | 0/180 (0%) | Not estimable | - | VERY LOW |
| Treatment failure (Composite outcome3) | |||||||||||
| 2 | randomised trials | serious1 | no serious inconsistency | no serious indirectness | very serious5 | none | 29/174 (16.7%) | 29/180 (16.1%) | RR 1 (0.64 to 1.56) | 0 fewer per 1000 (from 58 fewer to 90 more) | VERY LOW |
The design of one of the included trials was compromised by providing no or inadequate information about whether allocation concealment or blinding was used and by not using intention to treat analysis.
There were no events in either trial which indicates that these trials were not powered for this outcome.
Treatment failure defined as a composite end-point comprising one or more of the following: death; persistence, recurrence or worsening of clinical signs or symptoms of presenting infection; any addition to or modification of the assigned intervention.
The number of events was very low.
From: Subsequent Treatment: guideline chapter seven
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