Summary of findings for the main comparison. Antibiotic prophylaxis compared to no treatment/placebo for the prevention of recurrent erysipelas and cellulitis.
| Antibiotic prophylaxis compared to no treatment/placebo for the prevention of recurrent erysipelas and cellulitis ‐ on prophylaxis | ||||||
| Patient or population: People with recurrent erysipelas or cellulitis Intervention: Antibiotic prophylaxis Comparison: No treatment/Placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| no treatment/placebo | Antibiotic prophylaxis | |||||
| Recurrence of cellulitis | Study population | RR 0.31 (0.13 to 0.72) | 513 (5 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | Number needed to treat for 1 additional beneficial outcome (NNTB) is 6 | |
| 316 per 1000 | 98 per 1000 (41 to 227) | |||||
| Incidence rate of cellulitis | Study population | RR 0.44 (0.22 to 0.89) | 473 (4 RCTs) |
⊕⊕⊕⊝ MODERATE 1 | ‐ | |
| 43 fewer episodes of cellulitis per 1000 person‐months in treatment group (from 8 fewer to 60 fewer) | ||||||
| Time to next episode of cellulitis | Not estimable | HR 0.51 (0.34 to 0.78) | 437 (3 RCTs) | ⊕⊕⊕⊝ MODERATE 1 | ‐ | |
| Hospitalisation | Study population | RR 0.77 (0.37 to 1.57) | 429 (3 RCTs) | ⊕⊕⊝⊝ LOW 2 | ‐ | |
| 74 per 1000 | 57 per 1000 (27 to 116) | |||||
| Any adverse reactions | Study population | RR 0.87 (0.58 to 1.30) | 469 (4 RCTs) | ⊕⊕⊝⊝ LOW 3 | ‐ | |
| 287 per 1000 | 250 per 1000 (166 to 373) | |||||
| Quality of life | ‐ | |||||
| *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% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: risk ratio; HR: hazard 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. | ||||||
1We downgraded by one level because of imprecision due to the low number of events and the small sample size (optimal information size ‐ OIS).
2 We downgraded by two levels because of imprecision due to the low number of events and the small sample size (OIS) and the 95% confidence interval overlapping the line of no effect and ranging from benefit to harm.
3We downgraded by two levels because of imprecision due to the considerable low number of events and the small sample size (OIS).
We decided not to downgrade any of the outcomes for risk of bias as we decided it was not serious enough to affect the overall quality of the outcome.