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Antibióticos para la faringitis

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Appendices

Appendix 1. Details of previous searches

For the 2011 update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2011, Issue 2, part of The Cochrane Library, www.thecochranelibrary.com (accessed 18 May 2011), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (November 2008 to May week 1, 2011) and EMBASE (November 2008 to May 2011).

In the previous update we searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library 2008, Issue 4) which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (January 1966 to November 2008) and EMBASE (January 1990 to November 2008).

MEDLINE and CENTRAL were searched using the search strategy shown below. We combined the MEDLINE search string with the Cochrane Highly Sensitive Search Strategy for identifying randomised trials in MEDLINE: sensitivity and precision‐maximising version (2008 revision) (Lefebvre 2011). We adapted the search string for EMBASE.

MEDLINE (Ovid)

# 1 explode Pharyngitis/
# 2 pharyngit$.mp.
# 3 explode Nasopharyngitis/
# 4 nasopharyngit$.mp.
# 5 explode Tonsillitis/
# 6 tonsillit$.mp.
# 7 sore throat*.mp.
# 8 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7
# 9 explode Anti‐Bacterial Agents/
# 10 antibiot$.mp.
# 11 #9 OR #10
# 12 #8 AND #11

(Embase.com used in 2011 update)
#1. 'pharyngitis'/exp AND [embase]/lim
#2. pharyngit*:ti,ab AND [2004‐2008]/py
#3. 'rhinopharyngitis'/exp AND [embase]/lim
#4. rhinopharyngit*:ti,ab OR nasopharyngit*:ti,ab [embase]/lim
#5. 'tonsillitis'/exp AND [embase]/lim
#6. tonsillit*:ti,ab AND [embase]/lim
#7. 'sore throat'/exp AND [embase]/lim
#8. 'sore throat':ti,ab OR 'sore throats':ti,ab embase]/lim
#9. #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8
#10. 'antibiotic agent'/exp AND [embase]/lim
#11. antibiotic*:ti,ab AND [embase]/lim
#12. #10 OR #11 619,306
#13. random*:ti,ab OR factorial*:ti,ab OR crossover*:ti,ab OR 'cross over':ti,ab OR placebo*:ti,ab OR assign*:ti,ab OR allocat*:ti,ab OR volunteer*:ti,ab AND [embase]/lim
#14. 'double blind':ti,ab OR 'double blinded':ti,ab OR 'single blind':ti,ab OR 'single blinded':ti,ab AND [embase]/lim
#15. 'crossover procedure'/exp AND [embase]/lim
#16. 'double blind procedure'/exp AND [embase]/lim
#17. 'single blind procedure'/exp AND [embase]/lim
#18. 'randomized controlled trial'/exp AND [embase]/lim
#19. #13 OR #14 OR #15 OR #16 OR #17 OR #18
#20. #9 AND #12 AND #19

(EMBASE search used in earlier versions of the review)
EMBASE (WebSPIRS)
#1 explode 'pharyngitis‐' / all subheadings in DEM,DER,DRM,DRR
#2 (pharyngit* in ti) or (pharyngit* in ab)
#3 explode 'rhinopharyngitis‐' / all subheadings in DEM,DER,DRM,DRR
#4 (nasopharyngit* in ti) or (nasopharyngit* in ab)
#5 explode 'tonsillitis‐' / all subheadings in DEM,DER,DRM,DRR
#6 (tonsillit* in ti) or (tonsillit* in ab)
#7 explode 'sore‐throat' / all subheadings in DEM,DER,DRM,DRR
#8 (sore throat in ti) or (sore throat in ab)
#9 #1 or #2 or #3 or #4 or #5 or #6 or #7 or #8
#10 'antibiotic‐agent' / all subheadings in DEM,DER,DRM,DRR
#11 (antibiotic* in ti) or (antibiotic* in ab)
#12 #10 or #11
#13 #9 and #12
#14 explode 'randomized‐controlled‐trial' / all subheadings
#15 explode 'controlled‐study' / all subheadings
#16 explode 'single‐blind‐procedure' / all subheadings
#17 explode 'double‐blind‐procedure' / all subheadings
#18 explode 'crossover‐procedure' / all subheadings
#19 explode 'phase‐3‐clinical‐trial' / all subheadings
#20 (randomi?ed controlled trial in ti) or (randomi?ed controlled trial in ab)
#21 ((random* or placebo* or double‐blind*)in ti) or ((random* or placebo* or double‐blind*)in ab)
#22 (controlled clinical trial* in ti) or (controlled clinical trial* in ab)
#23 (explode 'randomized‐controlled‐trial' / all subheadings) or (explode 'controlled‐study' / all subheadings) or (explode 'single‐blind‐procedure' / all subheadings) or (explode 'double‐blind‐procedure' / all subheadings) or (explode 'crossover‐procedure' / all subheadings) or (explode 'phase‐3‐clinical‐trial' / all subheadings) or ((randomi?ed controlled trial in ti) or (randomi?ed controlled trial in ab)) or (((random* or placebo* or double‐blind*)in ti) or ((random* or placebo* or double‐blind*)in ab)) or ((controlled clinical trial* in ti) or (controlled clinical trial* in ab))
#24 (nonhuman in der) not ((human in der)and (nonhuman in der))
#25 ((explode 'randomized‐controlled‐trial' / all subheadings) or (explode 'controlled‐study' / all subheadings) or (explode 'single‐blind‐procedure' / all subheadings) or (explode 'double‐blind‐procedure' / all subheadings) or (explode 'crossover‐procedure' / all subheadings) or (explode 'phase‐3‐clinical‐trial' / all subheadings) or ((randomi?ed controlled trial in ti) or (randomi?ed controlled trial in ab)) or (((random* or placebo* or double‐blind*)in ti) or ((random* or placebo* or double‐blind*)in ab)) or ((controlled clinical trial* in ti) or (controlled clinical trial* in ab))) not ((nonhuman in der) not ((human in der)and (nonhuman in der)))
#26 #13 and #25

Appendix 2. EMBASE (Elsevier) search strategy

#16 #11 AND #15
#15 #12 OR #13 OR #14
#14 azithromycin*:ab,ti OR clarithromycin*:ab,ti OR erythromycin*:ab,ti OR roxithromycin*:ab,ti OR macrolide*:ab,ti OR cefamandole*:ab,ti OR cefoperazone*:ab,ti OR cefazolin*:ab,ti OR cefonicid*:ab,ti OR
cefsulodin*:ab,ti OR cephacetrile*:ab,ti OR cefotaxime*:ab,ti OR cephalothin*:ab,ti OR cephapirin*:ab,ti OR cephalexin*:ab,ti OR cephaclor*:ab,ti OR cephadroxil*:ab,ti OR cephaloglycin*:ab,ti OR
cephradine*:ab,ti OR cephaloridine*:ab,ti OR ceftazidime*:ab,ti OR cephamycin*:ab,ti OR cefmetazole*:ab,ti OR cefotetan*:ab,ti OR cefoxitin*:ab,ti OR cephalosporin*:ab,ti OR cefpodoxime*:ab,ti OR
cefuroxime*:ab,ti OR cefixime*:ab,ti OR amoxicillin*:ab,ti OR amoxycillin*:ab,ti OR ampicillin*:ab,ti OR sulbactum*:ab,ti OR tetracyclin*:ab,ti OR clindamycin*:ab,ti OR lincomycin*:ab,ti OR doxycyclin*:ab,ti OR fluoroquinolone*:ab,ti OR ciprofloxacin*:ab,ti OR fleroxacin*:ab,ti OR enoxacin*:ab,ti OR norfloxacin*:ab,ti OR ofloxacin*:ab,ti OR pefloxacin*:ab,ti OR moxifloxacin*:ab,ti OR esparfloxacin*:ab,ti OR clindamicin*:ab,ti OR penicillin*:ab,ti OR ticarcillin*:ab,ti OR 'beta‐lactam':ab,ti OR 'beta‐lactams':ab,ti OR levofloxacin*:ab,ti OR trimethoprim*:ab,ti OR 'co‐trimoxazole':ab,ti
#13 antibiot*:ab,ti
#12 'antibiotic agent'/exp
#11 #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10
#10 (sore* NEAR/2 throat*):ab,ti
#9 ((throat* OR pharyn*) NEAR/3 (infect* OR inflam* OR strep*)):ab,ti
#8 'sore throat'/de
#7 (tonsil* NEAR/2 (infect* OR inflam*)):ab,ti
#6 tonsillit*:ab,ti
#5 'tonsillitis'/exp
#4 rhinopharyngit*:ab,ti OR nasopharyngit*:ab,ti
#3 'rhinopharyngitis'/de
#2 pharyngit*:ab,ti
#1 'pharyngitis'/exp

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 1

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Summary of findings.
Figures and Tables -
Figure 3

Summary of findings.

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 1 Symptom of sore throat on day 3.
Figures and Tables -
Analysis 1.1

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 1 Symptom of sore throat on day 3.

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 2 Symptom of sore throat on day 3: blind versus unblinded studies.
Figures and Tables -
Analysis 1.2

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 2 Symptom of sore throat on day 3: blind versus unblinded studies.

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 3 Symptom of sore throat on day 3: antipyretics versus no antipyretics.
Figures and Tables -
Analysis 1.3

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 3 Symptom of sore throat on day 3: antipyretics versus no antipyretics.

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 4 Symptom of sore throat on day 3: GABHS‐positive throat swab, negative swab, untested/inseparable.
Figures and Tables -
Analysis 1.4

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 4 Symptom of sore throat on day 3: GABHS‐positive throat swab, negative swab, untested/inseparable.

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 5 Symptom of sore throat at one week (6 to 8 days).
Figures and Tables -
Analysis 1.5

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 5 Symptom of sore throat at one week (6 to 8 days).

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 6 Symptom of sore throat at one week (6 to 8 days): blind versus unblinded studies.
Figures and Tables -
Analysis 1.6

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 6 Symptom of sore throat at one week (6 to 8 days): blind versus unblinded studies.

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 7 Symptom of sore throat at one week (6 to 8 days): GABHS‐positive throat swab, GABHS‐negative swab.
Figures and Tables -
Analysis 1.7

Comparison 1 Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat, Outcome 7 Symptom of sore throat at one week (6 to 8 days): GABHS‐positive throat swab, GABHS‐negative swab.

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 1 Symptom of fever on day 3.
Figures and Tables -
Analysis 2.1

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 1 Symptom of fever on day 3.

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 2 Symptom of fever on day 3: blinded versus unblinded studies.
Figures and Tables -
Analysis 2.2

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 2 Symptom of fever on day 3: blinded versus unblinded studies.

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 3 Symptom of fever on day 3: children compared with adults.
Figures and Tables -
Analysis 2.3

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 3 Symptom of fever on day 3: children compared with adults.

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 4 Symptom of fever at 1 week (6 to 8 days).
Figures and Tables -
Analysis 2.4

Comparison 2 Antibiotics versus control for the treatment of sore throat: symptom of fever, Outcome 4 Symptom of fever at 1 week (6 to 8 days).

Comparison 3 Antibiotics versus control for the treatment of sore throat: symptom of headache, Outcome 1 Symptom of headache on day 3.
Figures and Tables -
Analysis 3.1

Comparison 3 Antibiotics versus control for the treatment of sore throat: symptom of headache, Outcome 1 Symptom of headache on day 3.

Comparison 3 Antibiotics versus control for the treatment of sore throat: symptom of headache, Outcome 2 Symptom of headache on day 3: blinded versus unblinded studies.
Figures and Tables -
Analysis 3.2

Comparison 3 Antibiotics versus control for the treatment of sore throat: symptom of headache, Outcome 2 Symptom of headache on day 3: blinded versus unblinded studies.

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 1 Incidence of acute rheumatic fever within 2 months. Rheumatic fever defined by clinical diagnosis.
Figures and Tables -
Analysis 4.1

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 1 Incidence of acute rheumatic fever within 2 months. Rheumatic fever defined by clinical diagnosis.

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 2 Incidence of acute rheumatic fever within 2 months. Penicillin versus placebo.
Figures and Tables -
Analysis 4.2

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 2 Incidence of acute rheumatic fever within 2 months. Penicillin versus placebo.

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 3 Incidence of acute rheumatic fever within 2 months: early (pre‐1975) versus late studies (post‐1975).
Figures and Tables -
Analysis 4.3

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 3 Incidence of acute rheumatic fever within 2 months: early (pre‐1975) versus late studies (post‐1975).

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 4 Incidence of otitis media within 14 days. Otitis media defined by clinical diagnosis.
Figures and Tables -
Analysis 4.4

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 4 Incidence of otitis media within 14 days. Otitis media defined by clinical diagnosis.

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 5 Incidence of otitis media within 14 days: early (pre‐1975) versus late studies (post‐1975).
Figures and Tables -
Analysis 4.5

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 5 Incidence of otitis media within 14 days: early (pre‐1975) versus late studies (post‐1975).

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 6 Incidence of sinusitis within 14 days. Sinusitis defined by clinical diagnosis.
Figures and Tables -
Analysis 4.6

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 6 Incidence of sinusitis within 14 days. Sinusitis defined by clinical diagnosis.

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 7 Incidence of quinsy within 2 months. Quinsy defined by clinical diagnosis.
Figures and Tables -
Analysis 4.7

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 7 Incidence of quinsy within 2 months. Quinsy defined by clinical diagnosis.

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 8 Incidence of acute glomerulonephritis within 1 month. Acute glomerulonephritis defined by clinical diagnosis.
Figures and Tables -
Analysis 4.8

Comparison 4 Antibiotics versus placebo for the treatment of sore throat: incidence of complications, Outcome 8 Incidence of acute glomerulonephritis within 1 month. Acute glomerulonephritis defined by clinical diagnosis.

Antibiotics compared with placebo for sore throat

Patient or population: patients presenting with sore throat

Settings: community

Intervention: antibiotics

Comparison: placebo

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Corresponding risk

Assumed risk

Antibiotics

Placebo

Sore throat: day 3

0.66

0.72

0.68 to 0.76

3621 (15)

High

Sore throat: day 7

0.18

0.65

0.55 to 0.76

2974 (13)

High

Rheumatic fever

0.017

0.29

0.18 to 0.44

10,101 (16)

High

Based largely on risk in pre‐1960 trials

Glomerulonephritis

0.001

0.22

0.07 to 1.32

5147 (10)

Low

Sparse data: 2 cases only

Quinsy

0.023

0.14

0.05 to 0.39

2433 (8)

High

Otitis media

0.02

0.28

0.15 to 0.52

3760 (11)

High

*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.

Figures and Tables -
Comparison 1. Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Symptom of sore throat on day 3 Show forest plot

15

3621

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.59, 0.79]

2 Symptom of sore throat on day 3: blind versus unblinded studies Show forest plot

15

3621

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.59, 0.79]

2.1 Symptom of sore throat on day 3: blinded studies

12

2662

Risk Ratio (M‐H, Random, 95% CI)

0.65 [0.54, 0.78]

2.2 Symptom of sore throat on day 3: unblinded studies

3

959

Risk Ratio (M‐H, Random, 95% CI)

0.79 [0.60, 1.05]

3 Symptom of sore throat on day 3: antipyretics versus no antipyretics Show forest plot

5

1137

Risk Ratio (M‐H, Random, 95% CI)

0.58 [0.48, 0.70]

3.1 Symptom of sore throat on day 3: antipyretics administered

3

455

Risk Ratio (M‐H, Random, 95% CI)

0.52 [0.33, 0.81]

3.2 Symptom of sore throat on day 3: no antipyretics administered

2

682

Risk Ratio (M‐H, Random, 95% CI)

0.62 [0.55, 0.70]

4 Symptom of sore throat on day 3: GABHS‐positive throat swab, negative swab, untested/inseparable Show forest plot

15

3600

Risk Ratio (M‐H, Random, 95% CI)

0.68 [0.59, 0.78]

4.1 Symptom of sore throat on day 3: GABHS‐positive throat swab

11

1839

Risk Ratio (M‐H, Random, 95% CI)

0.58 [0.48, 0.71]

4.2 Symptom of sore throat on day 3: GABHS‐negative throat swab

6

736

Risk Ratio (M‐H, Random, 95% CI)

0.78 [0.63, 0.97]

4.3 Symptom of sore throat on day 3: untested for GABHS culture or combined inseparable data

3

1025

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.80, 1.00]

5 Symptom of sore throat at one week (6 to 8 days) Show forest plot

13

2974

Risk Ratio (M‐H, Random, 95% CI)

0.49 [0.32, 0.76]

6 Symptom of sore throat at one week (6 to 8 days): blind versus unblinded studies Show forest plot

13

2944

Risk Ratio (M‐H, Random, 95% CI)

0.57 [0.38, 0.86]

6.1 Symptom of sore throat at 1 week (6 to 8 days): blinded studies

9

1616

Risk Ratio (M‐H, Random, 95% CI)

0.62 [0.38, 1.03]

6.2 Symptom of sore throat at 1 week (6 to 8 days): unblinded studies

4

1328

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.08, 1.15]

7 Symptom of sore throat at one week (6 to 8 days): GABHS‐positive throat swab, GABHS‐negative swab Show forest plot

12

2524

Risk Ratio (M‐H, Random, 95% CI)

0.48 [0.29, 0.80]

7.1 Symptom of sore throat at 1 week (6 to 8 days): GABHS‐positive throat swab

7

1117

Risk Ratio (M‐H, Random, 95% CI)

0.29 [0.12, 0.70]

7.2 Symptom of sore throat at 1 week (6 to 8 days): GABHS‐negative throat swab

5

541

Risk Ratio (M‐H, Random, 95% CI)

0.73 [0.50, 1.07]

7.3 Symptom of sore throat at 1 week (6 to 8 days): GABHS untested

3

866

Risk Ratio (M‐H, Random, 95% CI)

0.35 [0.03, 4.47]

Figures and Tables -
Comparison 1. Antibiotics versus placebo for the treatment of sore throats: symptom of sore throat
Comparison 2. Antibiotics versus control for the treatment of sore throat: symptom of fever

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Symptom of fever on day 3 Show forest plot

7

1334

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.45, 1.10]

2 Symptom of fever on day 3: blinded versus unblinded studies Show forest plot

7

1334

Risk Ratio (M‐H, Random, 95% CI)

0.71 [0.45, 1.10]

2.1 Symptom of fever on day 3: blinded studies.

4

703

Risk Ratio (M‐H, Random, 95% CI)

0.82 [0.54, 1.23]

2.2 Symptom of fever on day 3: unblinded studies.

3

631

Risk Ratio (M‐H, Random, 95% CI)

0.65 [0.31, 1.37]

3 Symptom of fever on day 3: children compared with adults Show forest plot

4

657

Risk Ratio (M‐H, Random, 95% CI)

0.51 [0.18, 1.46]

3.1 Symptom of fever on day 3: children

2

61

Risk Ratio (M‐H, Random, 95% CI)

1.27 [0.76, 2.13]

3.2 Symptom of fever on day 3: adults

2

596

Risk Ratio (M‐H, Random, 95% CI)

0.29 [0.06, 1.51]

4 Symptom of fever at 1 week (6 to 8 days) Show forest plot

3

777

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 2. Antibiotics versus control for the treatment of sore throat: symptom of fever
Comparison 3. Antibiotics versus control for the treatment of sore throat: symptom of headache

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Symptom of headache on day 3 Show forest plot

3

911

Risk Ratio (M‐H, Random, 95% CI)

0.44 [0.27, 0.71]

2 Symptom of headache on day 3: blinded versus unblinded studies Show forest plot

3

911

Risk Ratio (M‐H, Random, 95% CI)

0.44 [0.27, 0.71]

2.1 Symptom headache on day 3: blinded studies

2

436

Risk Ratio (M‐H, Random, 95% CI)

0.33 [0.09, 1.20]

2.2 Symptom of headache on day 3: unblinded studies

1

475

Risk Ratio (M‐H, Random, 95% CI)

0.55 [0.41, 0.72]

Figures and Tables -
Comparison 3. Antibiotics versus control for the treatment of sore throat: symptom of headache
Comparison 4. Antibiotics versus placebo for the treatment of sore throat: incidence of complications

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Incidence of acute rheumatic fever within 2 months. Rheumatic fever defined by clinical diagnosis Show forest plot

16

10101

Risk Ratio (M‐H, Random, 95% CI)

0.27 [0.12, 0.60]

2 Incidence of acute rheumatic fever within 2 months. Penicillin versus placebo Show forest plot

14

8175

Risk Ratio (M‐H, Random, 95% CI)

0.27 [0.14, 0.50]

3 Incidence of acute rheumatic fever within 2 months: early (pre‐1975) versus late studies (post‐1975) Show forest plot

16

10101

Risk Ratio (M‐H, Random, 95% CI)

0.27 [0.12, 0.60]

3.1 Incidence of acute rheumatic fever within 2 months: early (pre‐1975) studies

10

7617

Risk Ratio (M‐H, Random, 95% CI)

0.27 [0.12, 0.60]

3.2 Incidence of acute rheumatic fever within 2 months: late (post‐1975) studies

6

2484

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

4 Incidence of otitis media within 14 days. Otitis media defined by clinical diagnosis Show forest plot

11

3760

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.15, 0.58]

5 Incidence of otitis media within 14 days: early (pre‐1975) versus late studies (post‐1975) Show forest plot

11

3760

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.15, 0.58]

5.1 Incidence of otitis media within 14 days: early (pre‐1975) studies

5

1837

Risk Ratio (M‐H, Random, 95% CI)

0.30 [0.15, 0.62]

5.2 Incidence of otitis media within 14 days: late (post‐1975) studies

6

1923

Risk Ratio (M‐H, Random, 95% CI)

0.28 [0.03, 2.74]

6 Incidence of sinusitis within 14 days. Sinusitis defined by clinical diagnosis Show forest plot

8

2387

Risk Ratio (M‐H, Random, 95% CI)

0.48 [0.08, 2.76]

7 Incidence of quinsy within 2 months. Quinsy defined by clinical diagnosis Show forest plot

8

2433

Risk Ratio (M‐H, Random, 95% CI)

0.15 [0.05, 0.47]

8 Incidence of acute glomerulonephritis within 1 month. Acute glomerulonephritis defined by clinical diagnosis Show forest plot

10

5147

Risk Ratio (M‐H, Random, 95% CI)

0.22 [0.02, 2.08]

Figures and Tables -
Comparison 4. Antibiotics versus placebo for the treatment of sore throat: incidence of complications