Summary of findings 3. Rifampicin compared to doxycycline for treating scrub typhus.
| Rifampicin compared to doxycycline for treating scrub typhus | ||||||
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Patient or population: adults with scrub typhus Settings: hospitals in endemic areas Intervention: rifampicin Comparison: doxycycline | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (trials) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| doxycycline | rifampicin | |||||
| Treatment failure | The included reported no treatment failures. | ‐ | 78 (1 RCT) | ⊕⊝⊝⊝
VERY LOWa,b Due to risk of bias and imprecision |
We are uncertain whether rifampicin compared to doxycycline affects treatment failure, as the certainty of the evidence is very low. | |
| Resolution of fever within 48 hours | 464 per 1000 | 780 per 1000 (510 to 1000) | RR 1.68 (1.10 to 2.57) |
78 (1 RCT) | ⊕⊝⊝⊝
VERY LOWa,c Due to risk of bias and imprecision |
We are uncertain whether rifampicin compared to doxycycline affects the proportion of patients with resolution of fever within 48 hours, as the certainty of the evidence is very low. |
| Resolution of fever within 5 days | Not reported | The study did not look at resolution of fever within 5 days. | ||||
| Time to defervescence | Study authors report that time to defervescence was less with rifampicin. | ‐ | 78 (1 RCT) | ⊕⊝⊝⊝
VERY LOWa,c Due to risk of bias and imprecision |
We are uncertain whether rifampicin compared to doxycycline affects time to defervescence, as the certainty of the evidence is very low. | |
| Serious adverse events | Not formally reported | |||||
| *The basis for the assumed risk (for example, 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). Abbreviations: CI: confidence interval; RCT: randomized controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High certainty: further research is very unlikely to change our confidence in the estimate of effect Moderate certainty: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate Low certainty: 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 certainty: we are very uncertain about the estimate | ||||||
aDowngraded by 2 due to very serious risk of bias. In Watt 2000, sequence generation, allocation concealment, and blinding were unclear; risk of attrition bias with incomplete follow‐up was high (67.8%), as was risk of other bias due to deviation from the trial protocol. bDowngraded by 2 due to very serious imprecision. Number of events is very small and does not meet optimum information size (< 300 events), and the sample size is small. cDowngraded by 1 due to serious imprecision. The sample size is small.