Summary of findings 9. Two weeks of AmBd + 5FC compared to two weeks of AmBd + FLU for HIV‐associated cryptococcal meningitis.
Two weeks of AmBd + 5FC compared to two weeks of AmBd + FLU for HIV‐associated cryptococcal meningitis | |||||
Patient or population: HIV‐infected individual with first episode of cryptococcal meningitis Setting: randomized controlled trial Intervention: 2 weeks of AmBd + 5FC Comparison: 2 weeks of AmBd + FLU | |||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | Number of participants (trials) | Certainty of the evidence (GRADE) | |
Risk with 2 weeks of AmBd + FLU | Risk with 2 weeks of AmBd + 5FC | ||||
Mortality: 10 weeks | 355 per 1000 | 320 per 1000 (245 to 423) | RR 0.90 (0.69 to 1.19) | 538 (4 RCTs) | ⊕⊕⊝⊝ LOW1,2 |
*The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). Abbreviations: 5FC: flucytosine; AmBd: amphotericin B deoxycholate; CI: confidence interval; FLU: fluconazole; RCT: randomized controlled trial; RR: risk ratio | |||||
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: 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 certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. |
1Downgraded one level for indirectness. Some participants received a lower dose of fluconazole than is currently recommended in combination with AmBd. A few participants in one study also received a different azole drug, voriconazole. 2Downgraded one level for imprecision. Few overall events.