Table 5.

Summary of GRADE evidence profile of TMP-SMX vs clindamycin

Outcome/timeframe	Study results and measurements	Absolute effect estimates		Certainty in effect estimates (quality of evidence)	Plain text summary
		Clindamycin	TMP/SMX
Treatment failure/1 month	OR 1.08 (95% CI 0.69 to 1.75) Based on data from 2673 patients in seven studies Follow-up 7–30 days	109 per 1000	119 per 1000	High Borderline imprecision*	There is no important difference in treatment failure.
		Difference: 10 more per 1000 (95% CI 53 fewer—41 more)
Recurrence within/1 month	OR 2.14 (95% CI 1.11 to 4.12) Based on data from 436 patients in one study Follow-up 30 days	68 per 1000	135 per 1000	Low Due to serious imprecision and serious inconsistency†	TMP/SMX probably results in higher risk of early abscess recurrence.
		Difference: 67 more per 1000 (95% CI 7 more—163 more)
Diarrhoea/1 month	OR 0.29 (95% CI 0.16 to 0.55) Based on data from 526 patients in one study Follow-up 30 days	162 per 1000	53 per 1000	High‡	TMP/SMX has a lower risk of diarrhoea.
		Difference: 109 fewer per 1000 (95% CI 132 fewer—66 fewer)
Nausea/1 month	OR 1.9 (95% CI 0.69 to 5.21) Based on data from 526 patients in one study Follow-up 30 days	23 per 1000	43 per 1000	Moderate Due to serious imprecision§	There is probably not an important difference in risk of nausea.
		Difference: 20 more per 1000 (95% CI 7 fewer—86 more)

*Imprecision: no serious. Borderline wide CIs.

†Imprecision: serious. Data from one study only; CI approaches no difference; inconsistency: serious. The results are not consistent with the subgroup analysis, nor with the indirect evidence.

‡Imprecision: no serious. Direct data from one study only. However, we did not rate down for imprecision because of high certainty indirect evidence from other conditions that clindamycin has a higher risk of diarrhoea than TMP/SMX.

§Imprecision: serious. Data from one study only; wide CIs.

GRADE, Grading of Recommendations Assessment, Development and Evaluation; TMP-SMX, trimethoprim and sulfamethoxazole.