Table 8.
Pooled results and certainty assessment of randomized clinical trials and observational studies involving children receiving different prophylactic antibiotics (ninth clinical question).
| Certainty Assessment | No. of Patients | Effect | Certainty | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. of Studies | Study Design | Risk of Bias | Inconsistency | Indirectness | Imprecision | Other Considerations | Antibiotic Prophylaxis with Co-Trimoxazole | Oral Cephalosporins | Relative (95% CI) |
Absolute (95% CI) |
|
| Risk of UTI recurrence (follow-up: mean 12 months; assessed as rates of recurrence) | |||||||||||
| 1 [65] | randomized trials | not serious a | not serious | not serious | Serious b | none | 10/75 (13.3%) | 8/78 (10.3%) |
RR 1.30 (0.54 to 3.12) |
31 more per 1000 (47 fewer–217 more) |
⨁⨁⨁◯ Moderate |
| Risk of UTI recurrence (follow-up: mean 25 months; assessed as rates of recurrence) | |||||||||||
| 1 [66] | observational studies | not serious c | not serious | not serious | very serious b | none | 66/205 (32.2%) | 36/144 (25.0%) |
RR 1.29 (0.91 to 1.82) |
73 more per 1000 (22 fewer–205 more) |
⨁◯◯◯ Very low |
| Risk of new antimicrobial resistances (follow-up: mean 25 months; assessed as rates of infections resistant to empiric antibiotics) | |||||||||||
| 1 [66] | observational studies | not serious c | not serious | not serious | very serious b | very strong association | 4/66 (6.1%) | 17/33 (51.5%) |
RR 0.12 (0.04 to 0.32) |
453 fewer per 1000 (495 fewer–350 fewer) |
⨁⨁◯◯ Low |
CI: confidence interval; HR: hazard ratio; OR: odds ratio; RR: risk ratio. a: complete risk of bias analysis with results for single domains of the RoB2 tool is presented in Supplementary Materials. b: OIS criterion is not met and 95% CI overlaps no effect. c: complete risk of bias analysis with results for Newcastle–Ottawa Scale tool is presented in Supplementary Tables and Figures.