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Azithromycin untuk jangkitan saluran pernafasan rendah akut

Appendices

Appendix 1. Original search strategy

We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2007, Issue 2), MEDLINE (January 1966 to July 2007) and EMBASE (January 1974 to July 2007).

We combined the following search strategy with the Cochrane highly sensitive search strategy phases one and two as published in appendix 5c of the Cochrane Handbook for Systematic Reviews of Interventions (Lefebvre 2011). The search terms were also run over CENTRAL. See Appendix 3 for the EMBASE search strategy.

MEDLINE (OVID)
1 exp Azithromycin/
2 (azithromycin or azithromicin).mp.
3 or/1‐2
4 exp Amoxicillin/
5 exp Amoxicillin‐Potassium Clavulanate Combination/
6 (amoxicillin or amoxycillin).mp.
7 amoxicillin clavula$.mp.
8 or/4‐7
9 exp Pneumonia/
10 pneumonia.mp.
11 exp Bronchitis/
12 bronchitis.mp.
13 (lower respiratory tract infection$ or lower respiratory infection$ or LTRI$).mp.
14 or/9‐13
15 and/3,8,14

EMBASE (WebSPIRS)
#1 explode 'azithromycin‐' / all subheadings in DEM,DER,DRM,DRR
#2 (azithromycin or azithromicin) in ti
#3 (azithromycin or azithromicin) in ab
#4 #1 or #2 or #3
#5 explode 'amoxicillin‐' / all subheadings in DEM,DER,DRM,DRR
#6 explode 'amoxicillin‐plus‐clavulanic‐acid' / all subheadings in DEM,DER,DRM,DRR
#7 (amoxicillin or amoxycillin) in ti
#8 (amoxicillin or amoxycillin) in ab
#9 (amoxicillin clavula* in ti) or (amoxicillin clavula* in ab)
#10 #5 or #6 or #7 or #8 or #9
#11 explode 'pneumonia‐' / all subheadings in DEM,DER,DRM,DRR
#12 (pneumonia in ti) or (pneumonia in ab)
#13 explode 'bronchitis‐' / all subheadings in DEM,DER,DRM,DRR
#14 (bronchitis in ti) or (bronchitis in ab)
#15 explode 'lower‐respiratory‐tract‐infection' / all subheadings in DEM,DER,DRM,DRR
#16 (lower respiratory tract infection$ or lower respiratory infection$ or LTRI$)in ti
#17 (lower respiratory tract infection$ or lower respiratory infection$ or LTRI$)in ab
#18 #11 or #12 or #13 or #14 or #15 or #16 or #17
#19 #4 and #10 and #18

Appendix 2. MEDLINE (Ovid) search strategy

1 exp Pneumonia/
2 (pneumon* or bronchopneumon* or pleuropneumon*).tw.
3 exp Bronchitis/
4 (bronchit* or bronchiol*).tw.
5 (infect* adj2 lower respiratory).tw.
6 lrti.tw.
7 ((chest or lung) adj2 infect*).tw.
8 or/1‐7
9 Azithromycin/
10 (azithromycin or azithromicin).tw,nm.
11 9 or 10
12 exp Amoxicillin/
13 (amoxicillin* or amoxycillin*).tw,nm.
14 (amoxyclav* or amoxy‐clav* or co‐amoxyclav* or augmentin).tw,nm.
15 or/12‐14

Appendix 3. EMBASE (Elsevier) search strategy

#2.8 #2.3 NOT #2.7805950
#2.7 #2.4 NOT #2.6
#2.6 #2.4 AND #2.5
#2.5 'human'/de AND [embase]/lim
#2.4 'animal'/de OR 'nonhuman'/de OR 'animal experiment'/de AND [embase]/lim
#2.3 #2.1 OR #2.2
#2.2 random*:ab,ti OR placebo*:ab,ti OR crossover*:ab,ti OR 'cross over':ab,ti OR allocat*:ab,ti OR trial:ti OR (doubl* NEXT/1 blind*):ab,ti AND [embase]/lim
#2.1 'randomized controlled trial'/exp OR 'single blind procedure'/exp OR 'double blind procedure'/exp OR 'crossover procedure'/exp AND [embase]/lim

#1 2066
#1.16 #1.7 AND #1.10 AND #1.152066
#1.15 #1.11 OR #1.12 OR #1.13 OR #1.14
#1.14 amoxyclav*:ab,ti OR 'co‐amoxyclav':ab,ti OR augmentin:ab,ti AND [embase]/lim
#1.13 'amoxicillin plus clavulanic acid'/de AND [embase]/lim
#1.12 amoxycillin*:ab,ti OR amoxicillin*:ab,ti AND [embase]/lim
#1.11 'amoxicillin'/de AND [embase]/lim
#1.10 #1.8 OR #1.9
#1.9 aziththromycin*:ab,ti OR azythromycin*:ab,ti OR azithromicin*:ab,ti AND [embase]/lim
#1.8 'azithromycin'/de AND [embase]/lim
#1.7 #1.1 OR #1.2 OR #1.3 OR #1.4 OR #1.5 OR #1.6
#1.6 (infection* NEAR/2 'lower respiratory'):ab,ti AND [embase]/lim
#1.5 'lower respiratory tract infection'/de OR 'chest infection'/de OR 'lung infection'/de AND [embase]/lim
#1.4 bronchit*:ab,ti OR bronchiolit*:ab,ti AND [embase]/lim
#1.3 'bronchitis'/exp AND [embase]/lim
#1.2 pneumon*:ab,ti OR bronchopneumon*:ab,ti OR pleuropneumon*:ab,ti AND [embase]/lim
#1.1 'pneumonia'/exp AND [embase]/lim

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
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.
Figuras y tablas -
Figure 2

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

Funnel plot of comparison: 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, outcome: 1.1 Clinical failure.
Figuras y tablas -
Figure 3

Funnel plot of comparison: 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, outcome: 1.1 Clinical failure.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 1 Clinical failure.
Figuras y tablas -
Analysis 1.1

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 1 Clinical failure.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 2 Clinical failure by diagnosis.
Figuras y tablas -
Analysis 1.2

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 2 Clinical failure by diagnosis.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 3 Clinical failure by age group.
Figuras y tablas -
Analysis 1.3

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 3 Clinical failure by age group.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 4 Clinical failure by dose regimen of azithromycin.
Figuras y tablas -
Analysis 1.4

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 4 Clinical failure by dose regimen of azithromycin.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 5 Clinical failure by type of antibiotic in control group.
Figuras y tablas -
Analysis 1.5

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 5 Clinical failure by type of antibiotic in control group.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 6 Sensitivity analysis excluding one large trial.
Figuras y tablas -
Analysis 1.6

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 6 Sensitivity analysis excluding one large trial.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 7 Sensitivity analysis excluding three trials with missing data > 10%.
Figuras y tablas -
Analysis 1.7

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 7 Sensitivity analysis excluding three trials with missing data > 10%.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 8 Sensitivity analysis with the condition of concealment.
Figuras y tablas -
Analysis 1.8

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 8 Sensitivity analysis with the condition of concealment.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 9 Microbial eradication.
Figuras y tablas -
Analysis 1.9

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 9 Microbial eradication.

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 10 Adverse events.
Figuras y tablas -
Analysis 1.10

Comparison 1 Azithromycin versus amoxycillin or amoxycillin‐clavulanate, Outcome 10 Adverse events.

Comparison 1. Azithromycin versus amoxycillin or amoxycillin‐clavulanate

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Clinical failure Show forest plot

15

2496

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.64, 1.85]

2 Clinical failure by diagnosis Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Acute bronchitis

6

1296

Risk Ratio (M‐H, Random, 95% CI)

0.63 [0.45, 0.88]

2.2 Acute exacerbation of chronic bronchitis

9

808

Risk Ratio (M‐H, Random, 95% CI)

1.24 [0.46, 3.32]

2.3 Pneumonia

5

392

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.45, 1.94]

3 Clinical failure by age group Show forest plot

15

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

3.1 Adult

12

2112

Risk Ratio (M‐H, Random, 95% CI)

1.15 [0.60, 2.20]

3.2 Paediatric

3

384

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.45, 1.94]

4 Clinical failure by dose regimen of azithromycin Show forest plot

12

2112

Risk Ratio (M‐H, Random, 95% CI)

1.15 [0.60, 2.20]

4.1 500 mg once daily x 3

8

1631

Risk Ratio (M‐H, Random, 95% CI)

1.25 [0.55, 2.83]

4.2 500 mg single dose followed by 250 mg on day 2 to 5

4

481

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.25, 3.62]

5 Clinical failure by type of antibiotic in control group Show forest plot

15

2496

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.64, 1.85]

5.1 Amoxycillin

2

291

Risk Ratio (M‐H, Random, 95% CI)

0.41 [0.16, 1.05]

5.2 Amoxyclav

13

2205

Risk Ratio (M‐H, Random, 95% CI)

1.28 [0.71, 2.30]

6 Sensitivity analysis excluding one large trial Show forest plot

14

1742

Risk Ratio (M‐H, Random, 95% CI)

1.20 [0.69, 2.09]

7 Sensitivity analysis excluding three trials with missing data > 10% Show forest plot

12

2250

Risk Ratio (M‐H, Random, 95% CI)

1.13 [0.62, 2.03]

8 Sensitivity analysis with the condition of concealment Show forest plot

15

2496

Risk Ratio (M‐H, Random, 95% CI)

1.09 [0.64, 1.85]

8.1 Adequately concealed studies

3

281

Risk Ratio (M‐H, Random, 95% CI)

0.55 [0.25, 1.21]

8.2 Inadequately or unclearly concealed studies

12

2215

Risk Ratio (M‐H, Random, 95% CI)

1.32 [0.70, 2.49]

9 Microbial eradication Show forest plot

12

961

Risk Ratio (M‐H, Random, 95% CI)

0.95 [0.87, 1.03]

10 Adverse events Show forest plot

12

2406

Risk Ratio (M‐H, Random, 95% CI)

0.76 [0.57, 1.00]

Figuras y tablas -
Comparison 1. Azithromycin versus amoxycillin or amoxycillin‐clavulanate