Review: antibiotics did not lead to general improvement in upper respiratory tract infections [commentary on Arroll B, Kenealy T. Antibiotics versus placebo in the common cold. (Cochrane Review, latest version 8 Apr 1998). In: Cochrane Library. Oxford: Update Software].
Question: What is the efficacy and safety of antibiotics for acute upper respiratory tract infections? Data sources: Published and unpublished studies were identified by searching Medline (1966-97) with the content terms antibiotics, respiratory tract infections (upper), common cold, and pharyngitis...
| Publicado en: | Evidence Based Nursing pp. 78 - 79 |
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| Autor principal: | |
| Formato: | abstract commentary Journal Article |
| Publicado: |
BMJ Publishing Group
Jul1999
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107098082&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107098082 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13676539 C0J jtl: Evidence Based Nursing issn: 13676539 maglogo: N pubinfo: dt: Jul1999 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 107098082 107098082 2000016550 107098082 ppf: 78 ppct: 1 formats: tig: atl: Review: antibiotics did not lead to general improvement in upper respiratory tract infections [commentary on Arroll B, Kenealy T. Antibiotics versus placebo in the common cold. (Cochrane Review, latest version 8 Apr 1998). In: Cochrane Library. Oxford: Update Software]. aug: au: Nicoteri JA affil: Family Nurse Practitioner/Faculty, University of Scranton, Scranton, Pennsylvania sug: subj: Antibiotics Therapeutic Use Common Cold Drug Therapy Systematic Review Meta Analysis Clinical Trials Treatment Outcomes Placebos Infant Child, Preschool Child Adolescence Adult Middle Age Respiratory Tract Infections Drug Therapy Respiratory Tract Infections Etiology Virus Diseases Antibiotics Adverse Effects Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years ab: Question: What is the efficacy and safety of antibiotics for acute upper respiratory tract infections? Data sources: Published and unpublished studies were identified by searching Medline (1966-97) with the content terms antibiotics, respiratory tract infections (upper), common cold, and pharyngitis; Embase/Excerpta Medica; the Family Medicine Database (Canadian College of Family Physicians Library); and the Cochrane Clinical Trials register. Bibliographies of relevant studies, review articles, and textbook chapters were reviewed and primary investigators of studies were contacted. Study selection: Randomised controlled trials were selected if they included patients with acute upper respiratory tract infection (with symptoms including rhinitis, sore throat, cough, or productive sputum) who were allocated to antibiotics or placebo and if outcomes included resolution of symptoms of nasopharyngeal inflammation, global ratings of health, or adverse effects. Studies were excluded if > 5% of patients tested positive for streptococcal infection; patients had a known bacterial diagnosis, bronchitis, or history of serious illness; if antibiotics were given prophylactically; or if the process of randomisation was questionable. Data extraction: Data were extracted on study design, participants, intervention, and outcomes. Studies were assessed for methodological quality in terms of randomisation, co-interventions, follow up, and blinding. Main results: 7 trials were included in the analysis. Study drugs included tetracycline, penicillin, ampicillin, amoxycillin and amoxycillin with clavulinic acid, erythromycin, and co-trimoxazole. Metaanalysis of 5 trials (n= 1935) using a fixed effects model found no difference between antibiotics and placebo for general improvement at 1 to 7 days {weighted event rates 51.2% v 52.5%, p=0.43}. Meta-analysis of 4 studies (n=1908) using a random effects model (because of significant heterogeneity) found a non-significant increase in adverse effects among patients who received antibiotics compared with those who received placebo {weighted event rates 9.7% v 3.6%, p=0.11}. 1 study examined nasal discharge and found a modest benefit at 8 days. Another study found a significant benefit for antibiotics in a small subset of patients with positive nasopharyngeal aspirates for 1 of 3 respiratory pathogens (Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae). Conclusion: Among patients with acute upper respiratory tract infection, antibiotics have no benefit for general improvement compared with placebo, and are associated with a non-significant increase in adverse effects. pubtype: Academic Journal doctype: abstract commentary Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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