Summary of findings 5.
Clindamycin plus aminoglycoside compared to cephalosporin for pelvic inflammatory disease
| Clindamycin plus aminoglycoside compared to cephalosporin for pelvic inflammatory disease | ||||||
|
Population: women with PID Setting: hospital ward or outpatient clinic Intervention: clindamycin + aminoglycoside Comparison: cephalosporin | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No of women (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with cephalosporin | Risk with clindamycin plus aminoglycoside | |||||
|
Clinical cure according to criteria established by authors Mild‐moderate PID Follow‐up: median 14 days |
69/72 958 per 1000 |
76/78 974 per 1000 (911 to 993) |
RR 1.02 (0.95 to 1.09) NNTB 11 to NNTH 19 |
150 (2 RCTs) | ⊕⊕⊝⊝ Low1,2 | ‐ |
|
Clinical cure according to criteria established by authors Severe PID Follow‐up: median 14 days |
441/525 840 per 1000 |
364/434 838 per 1000 (801 to 870) |
RR 1.0 (0.95 to 1.06) NNTB 21 to NNTH 22 |
959 (10 RCTs) | ⊕⊕⊕⊝ Moderate1 | ‐ |
|
Adverse events: any antibiotic‐related adverse event leading to discontinuation of therapy Follow‐up: mean 14 days |
3/670 4 per 1000 |
3/502 6 per 1000 (2 to 17) |
RR 0.78 (0.18 to 3.42) NNTB 75 to NNTH 126 |
1172 (10 RCTs) | ⊕⊝⊝⊝ Very low1,3 | 7/10 RCTs (617 women) did not contribute data to the analysis reported 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 one level for serious risk of bias (poor reporting of methods and high or unclear risk of performance and detection bias in one or more studies).
2 Downgraded one level for serious imprecision, small overall sample size.
3 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, only six events overall.