Summary of findings 4. Iodine versus topical antibiotics.
| Iodine versus topical antibiotics | ||||||
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Patient or population: people with burns Intervention: iodine‐based treatments Comparison: topical antibiotics (SSD) Setting: hospitals and burn clinics | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with topical antibiotics | Risk with iodine‐based treatments | |||||
| Wound healing (mean time to healing) | The mean time to wound healing was 20.07 days | The mean time to wound healing in the intervention group was 0.47 days shorter (2.76 shorter to 1.83 longer) | MD ‐0.47 (‐2.76 to 1.83) | 148 (2 RCTs) | ⊕⊝⊝⊝ Very low1 | It is uncertain whether there is a difference in mean time to wound healing between iodine‐based antiseptic treatments and SSD |
| Infection | No study reported evaluable data for infection | |||||
| Adverse events | 350 per 1000 | 301 per 1000 (122 to 735) | RR 0.86 (0.35 to 2.10) | 40 (1 RCT) | ⊕⊝⊝⊝ Very low2 | It is uncertain whether there is a difference in the proportion of participants with adverse events between iodine‐based antiseptic treatments and SSD |
| Risk difference: 48 fewer participants with adverse events per 1000 with iodine‐based treatments than with SSD (227 fewer to 385 more) | ||||||
| *The risk in the intervention group (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; MD: mean difference; RR: risk ratio; SSD: silver sulfadiazine | ||||||
| GRADE Working Group grades of evidence High: it is very likely that the effect will be close to what was found in the research. Moderate: it is likely that the effect will be close to what was found in the research, but there is a possibility that it will be substantially different. Low: it is likely that the effect will be substantially different from what was found in the research, but the research provides an indication of what might be expected. Very low: the anticipated effect is very uncertain and the research does not provide a reliable indication of what might be expected. | ||||||
1Downgraded once for detection bias in one trial accounting for 61% of the analysis weight and twice for imprecision due to low participant numbers and confidence intervals that cross the line of no effect; one study also had an intra‐individual design, which may not have been accounted for in the analysis, this is taken account of in the double downgrading for imprecision. 2Downgraded once for detection bias in the single trial and twice for imprecision due to fragile confidence intervals, which cross the line of no effect.