Summary of findings 2. Systemic antibiotics alone versus systematic antibiotics plus antibiotic lock solution.
| Systemic antibiotics alone versus systematic antibiotics plus antibiotic lock solution | |||||
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Patient or population: patients on maintenance HD with CRBSI Settings: inpatient Intervention: systemic antibiotics alone Comparison: systemic antibiotics and antibiotic lock solution (ethanol) | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Quality of the evidence (GRADE) | |
| Risk with systemic antibiotics alone | Risk with systemic antibiotic plus ethanol antibiotic lock solution | ||||
| Cure: successful eradication of the infection Follow‐up: 2 days |
563 per 1000 |
906 per 1000 (653 to 1000) |
RR 1.61 (1.16 to 2.23) |
64 (1) | ⊕⊝⊝⊝ 1,2,3 very low |
| Stenosis or thrombosis of vascular access site after catheter removal | Not reported | Not reported | ‐ | ‐ | ‐ |
| Death | Not reported | Not reported | ‐ | ‐ | ‐ |
| Development of antibiotic resistance | Not reported | Not reported | ‐ | ‐ | ‐ |
| Adverse effects | Not reported | Not reported | ‐ | ‐ | ‐ |
| *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). CI: Confidence interval; CRBSI: Catheter‐related bloodstream infection; HD: Haemodialysis; 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. | |||||
1High risk of bias in selective reporting because of retrospective trial registration (reporting bias) and other bias once 45% of the included population have negative blood cultures; downgraded by 1 level (methodological limitation).
2Small number of participants and studies (doubt about the reproducibility of the data); downgraded by 1 level (imprecision).
3Outcome cure defined only by clinical improvement in signs and symptoms, without laboratory confirmation; downgraded by 1 level (indirectness).