Summary of findings 4.
Clindamycin plus aminoglycoside compared to quinolone for pelvic inflammatory disease
| Clindamycin plus aminoglycoside compared to quinolone for pelvic inflammatory disease | ||||||
|
Population: women with PID Setting: hospital ward or outpatient clinic Intervention: clindamycin + aminoglycoside Comparison: quinolone | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of women (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with quinolone | Risk with clindamycin + aminoglycoside | |||||
|
Clinical cure according to criteria established by authors Mild‐moderate PID Follow‐up: median 14 days |
10/10 1000 per 1000 |
13/15 867 per 1000 (621 to 962) |
RR 0.88 (0.69 to 1.13) NNTB 3 to NNTH 6 |
25 (1 RCT) | ⊕⊝⊝⊝ Very low1,2 | ‐ |
|
Clinical cure according to criteria established by authors Severe PID Follow‐up: median 14 days |
60/75 800 per 1000 |
62/76 816 per 1000 (714 to 887) |
RR 1.02 (0.87 to 1.19) NNTB 7 to NNTH 9 |
151 (2 RCTs) | ⊕⊕⊝⊝ Low3,4 | ‐ |
|
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Follow‐up: mean 14 days |
4/80 50 per 1000 |
0/83 0 per 1000 (0 to 44) |
RR 0.21 (0.02 to 1.72) NNTB 8 to NNTH 273 |
163 (3 RCTs) | ⊕⊝⊝⊝ Very low1,2 | 1/3 RCTs (25 women) did not contribute data to the analysis because the authors reported no events. |
| *The risk in the intervention group (and its 95% confidence interval) is based on the mean risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; NNTB: number needed to treat for an additional beneficial outcome; NNTH: number needed to treat for an additional harmful outcome; PID: pelvic inflammatory disease; RCT: randomized controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. | ||||||
1 Downgraded two levels for very serious risk of bias: single unblinded study with poor reporting of methods.
2 Downgraded two levels for serious imprecision (though further downgrading not possible): confidence intervals compatible with benefit in one or both groups, or with no difference between the groups, very few events overall.
3 Downgraded one level for serious risk of bias (poor reporting of methods and high or unclear risk of performance and detection bias in both studies).
4 Downgraded one level for serious imprecision: confidence intervals compatible with benefit in one or both groups, or with no difference between the groups.