Summary of findings for the main comparison. Antibiotic prophylaxis compared to no treatment for episiotomy repair following vaginal birth.
| Antibiotic prophylaxis compared to no treatment for episiotomy repair following vaginal birth | ||||||
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Patient or population: women with episiotomy repair following vaginal birth Settings: public hospital, Brazil Intervention: antibiotic prophylaxis with oral chloramphenicol 500 mg four times daily for 72 hours after episiotomy repair Comparison: no treatment | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Risk with no treatment | Risk with antibiotic prophylaxis | |||||
| Incidence of episiotomy wound infection with wound dehiscence | Study population | RR 0.13 (0.01 to 2.28) | 73 (1 quasi‐RCT) | ⊕⊝⊝⊝ very low1,2 | ||
| 103 per 1000 | 14 per 1000 (1 to 257) | |||||
| Incidence of episiotomy wound dehiscence without wound infection | Study population | RR 0.82 (0.29 to 2.34) | 73 (1 quasi‐RCT) | ⊕⊝⊝⊝ very low1,2 | ||
| 179 per 1000 | 151 per 1000 (52 to 439) | |||||
| Incidence of puerperal infection (endometritis) | Study population | not estimable | 73 (1 quasi‐RCT) | ⊕⊝⊝⊝ very low1,3 | There were no events in either group. | |
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Incidence of severe maternal infectious morbidity | Study population | ‐ | 0 (0 RCT) | ‐ | trial did not measure this outcome | |
| ‐ | ‐ | |||||
| Discomfort or pain at episiotomy wound site | ‐ | ‐ | ‐ | 0 (0 RCT) | ‐ | trial did not measure this outcome |
| Women's satisfaction with care | ‐ | ‐ | ‐ | 0 (0 RCT) | ‐ | trial did not measure this outcome |
| Adverse effects of antibiotics | Study population | ‐ | 0 (0 RCT) | ‐ | trial did not measure this outcome | |
| ‐ | ‐ | |||||
| *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; | ||||||
| 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. | ||||||
1 One study with very serious design limitations (‐2) 2 Wide confidence interval crossing the line of no effect, and few events (‐1) 3 No events (‐1)