2.
| Antibiotic treatment for spontaneous bacterial peritonitis in people with decompensated liver cirrhosis | ||||
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Patient or population: people with cirrhosis and spontaneous bacterial peritonitis Settings: secondary or tertiary care Intervention: various interventions Comparison: ceftriaxone Follow‐up period: 1 week to 3 months Network geometry plots: Figure 1 | ||||
| Outcomes | Cefotaxime | Ciprofloxacin | ||
| All‐cause mortality | ||||
| Ceftriaxone 263 per 1000 (26.3%) | HR 0.56 (0.11 to 2.28) Network estimate | 117 fewer per 1000 (235 fewer to 336 more) | HR 0.65 (0.12 to 2.72) Network estimate | 92 fewer per 1000 (232 fewer to 454 more) |
| Very low1,2,3 | Very low1,2,3 | |||
| Rank*: ‐ | Rank: ‐ | Rank: ‐ | ||
| Based on 37 participants (1 RCT) | Based on 35 participants (1 RCT) | |||
| Adverse events (proportion of participants) | ||||
| Ceftriaxone 67 per 1000 (6.7%) | OR 0.64 (0.15 to 2.62) Network estimate | 23 fewer per 1000 (56 fewer to 91 more) | OR 1.02 (0.24 to 4.16) Network estimate | 1 more per 1000 (50 fewer to 162 more) |
| Very low1,2,3 | Very low1,2,3 | |||
| Rank: ‐ | Rank: ‐ | Rank: ‐ | ||
| Based on 37 participants (1 RCT) | Based on 35 participants (1 RCT) | |||
| Spontaneous bacterial peritonitis (as per definition used for spontaneous bacterial peritonitis) | ||||
| Ceftriaxone 733 per 1000 (73.3%) | HR 0.90 (0.42 to 1.86) Network estimate | 73 fewer per 1000 (425 fewer to 267 more) | HR 0.93 (0.69 to 1.25) Network estimate | 54 fewer per 1000 (230 fewer to 183 more) |
| Very low1,2,3 | Very low1,2,3 | |||
| Rank: ‐ | Rank: ‐ | Rank: ‐ | ||
| Based on 37 participants (1 RCT) | Based on 275 participants (2 RCT) | |||
| Other features of decompensation (per participant) | ||||
| Ceftriaxone 368 per 1000 (36.8 per 100 participants) | Rate ratio 1.22 (0.43 to 3.53) Network estimate | 80 more per 1000 (209 fewer to 933 more) | Rate ratio 1.01 (0.32 to 3.16) Network estimate | 4 more per 1000 (249 fewer to 795 more) |
| Very low1,2,3 | Very low1,2,3 | |||
| Rank: ‐ | Rank: ‐ | Rank: ‐ | ||
| Based on 37 participants (1 RCT) | Based on 35 participants (1 RCT) | |||
| *Ranking is not provided as the median rank was not 1 for at least one of the ranking positions for each intervention for the outcome. CrI: credible interval; HR: hazard ratio; OR: odds ratio; RCT: randomised clinical trial | ||||
| 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. | ||||
aThe trial(s) included in the analysis was/were at high risk of bias (downgraded one level). bThe sample size was small (downgraded one level). cThe credible intervals were wide (includes clinical benefit and harms) (downgraded one level).