9. Summary of findings table: intravenous doxycycline compared to intravenous penicillin G for Lyme neuroborreliosis (acute and chronic).
| Intravenous doxycycline compared to intravenous penicillin G for Lyme neuroborreliosis (acute and chronic) | ||||||
| Patient or population: Lyme neuroborreliosis (acute and chronic) Settings: Southern Germany, hospital Intervention: intravenous doxycycline Comparison: intravenous penicillin G | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk or score/value | Corresponding risk or score/value | |||||
| Intravenous penicillin G | Intravenous doxycycline | |||||
| Improvement in a measure of overall disability in the long term (3 or more months) following treatment | See comment | See comment | Not estimable | ‐ | See comment | Not reported |
| Improvement of the person's presenting neurological deficits in the long term (3 or more months) following treatment1 | 833 per 1000 | 817 per 1000 (667 to 1000) | RR 0.98 (0.80 to 1.21) | 75 (1 study) | Low2 | Clinical findings were classified as no remission, partial remission, or full remission. |
| Resolution of the person's presenting neurological deficits in the long term (3 or more months) following treatment1 | 694 per 1000 | 667 per 1000 (486 to 910) |
RR 0.96 (0.70 to 1.31) |
75 (1 study) | Low2 | Clinical findings were classified as no remission, partial remission, or full remission. |
| Improvement in a measure of overall disability in the short term (2 weeks) following treatment | See comment | See comment | Not estimable | ‐ | See comment | Not reported |
| Resolution of CSF pleocytosis following treatment | See comment | See comment | Not estimable | ‐ | ‐ | Measured but not reported in detail |
| All adverse events3 | See comment | See comment | Not estimable | 75 (1 study) | ‐ | 'Adverse events' not reported. No serious adverse events occurred. |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; CSF: cerebrospinal fluid; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate. Evidence based on randomized controlled trials begins as high‐quality evidence, but confidence in the evidence was decreased for several reasons, including the following.
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1Measured at 6 and 12 months; 12‐month results reported here. 2Downgraded twice: for study limitations (unclear risk of selection bias, lack of blinding) and imprecision (small sample size). We did not downgrade the quality of evidence for indirectness as, although flawed, the measure is likely to reflect clinical reality. 3In the absence of comprehensive adverse event reporting in the included trials, the table presents ‘all adverse events’ with a comment on severe adverse events when these data are presented in the trial.