Antibiotic use for irreversible pulpitis
Información
- DOI:
- https://doi.org/10.1002/14651858.CD004969.pub4Copiar DOI
- Base de datos:
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- Cochrane Database of Systematic Reviews
- Versión publicada:
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- 17 febrero 2016see what's new
- Tipo:
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- Intervention
- Etapa:
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- Review
- Grupo Editorial Cochrane:
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Grupo Cochrane de Salud oral
- Copyright:
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- Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cifras del artículo
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Autores
Contributions of authors
Zbys Fedorowicz (ZF), Esther van Zuuren (EvZ), Anirudha Agnihotry (AA), Allan Farman (AF) and Jassim Hasan Al‐Langawi (JHL) were responsible for data collection for the review; screening search results; screening retrieved papers against inclusion criteria; appraising risk of bias of papers; extracting data from papers; obtaining and screening data on unpublished studies; entering data into RevMan; analysis and interpretation of data; and writing the review.
ZF and AA were responsible for organising retrieval of papers.
ZF and AA were responsible for writing to authors of papers for additional information; and providing additional data about papers.
ZF was responsible for designing and coordinating the review; and performing previous work that was the foundation of current study.
ZF, AA and EvZ were responsible for data management for the review.
ZF conceived the idea for the review.
AA will be the guarantor for the review.
Sources of support
Internal sources
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No sources of support supplied
External sources
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Cochrane Oral Health Group Global Alliance, Other.
Through our Global Alliance (ohg.cochrane.org/partnerships‐alliances), the Cochrane Oral Health Group has received support from: British Association for the Study of Community Dentistry, UK; British Association of Oral Surgeons, UK; British Orthodontic Society, UK; British Society of Paediatric Dentistry, UK; British Society of Periodontology, UK; Canadian Dental Hygienists Association, Canada; Mayo Clinic, USA; National Center for Dental Hygiene Research & Practice, USA; New York University College of Dentistry, USA; and Royal College of Surgeons of Edinburgh, UK
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National Institute for Health Research (NIHR), UK.
This project was supported by the NIHR, via Cochrane Infrastructure funding to the Cochrane Oral Health Group. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health
Declarations of interest
There are no financial conflicts of interest and the review authors declare that they do not have any associations with any parties who may have vested interests in the results of this review.
Acknowledgements
We would like to express our gratitude to the following: Anne Littlewood the Trials Search Co‐ordinator of the Cochrane Oral Health Review Group who executed the electronic searches for our review. To Emma Tavender who provided guidance on an earlier version of this review and Luisa Fernandez Mauleffinch who assisted with updating and copy edited this review. To Scott McLanahan, Professor of Endodontics at the Naval Postgraduate Dental School, Bethesda MD USA, the author of an article on this topic which provided the starting point for this review and who kindly agreed to continue providing advice. Our thanks are also due to Mohammed Ghali Rashid, the reference and serials librarian and ILL service co‐ordinator at the Arabian Gulf University Kingdom of Bahrain, who obtained some of the initial background references for this review. We would also like to acknowledge the contribution of two previous review authors James Keenan and Tim Newton.
Version history
| Published | Title | Stage | Authors | Version |
| 2019 May 30 | Antibiotic use for irreversible pulpitis | Review | Anirudha Agnihotry, Wendy Thompson, Zbys Fedorowicz, Esther J van Zuuren, Julie Sprakel | |
| 2016 Feb 17 | Antibiotic use for irreversible pulpitis | Review | Anirudha Agnihotry, Zbys Fedorowicz, Esther J van Zuuren, Allan G Farman, Jassim Hasan Al‐Langawi | |
| 2013 Dec 19 | Antibiotic use for irreversible pulpitis | Review | Zbys Fedorowicz, Esther J van Zuuren, Allan G Farman, Anirudha Agnihotry, Jassim Hasan Al‐Langawi | |
| 2005 Apr 20 | Antibiotic use for irreversible pulpitis | Review | Zbys Fedorowicz, James V Keenan, Allan G Farman, Tim Newton | |
| 2004 Oct 18 | Antibiotic use for irreversible pulpitis | Protocol | James V Keenan, Allan G Farman, Zbys Fedorowicz, Jonathan T Newton | |
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Adult; Female; Humans; Male;
PICO
Study flow diagram.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
| Core elements | Issues to consider | Status of research for this review |
| Evidence (E) | What is the current state of the evidence? | This systematic review identified 1 randomised controlled trial |
| Population (P) | Diagnosis, disease stage, comorbidity, risk factors, gender, age, ethnic group, specific inclusion or exclusion criteria, clinical setting | Inclusion criteria
Exclusion criteria
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| Intervention (I) | Type, frequency, dose, duration, prognostic factor | Any systemic antibiotic at any dosage and any analgesic at any dosage prescribed in the acute preoperative phase of irreversible pulpitis |
| Comparison (C) | Type, frequency, dose, duration, prognostic factor | Placebo and any analgesic, at any dosage, prescribed in the acute preoperative phase of irreversible pulpitis |
| Outcome (O) | Which clinical or patient‐related outcomes will the researcher need to measure, improve, influence, or accomplish? Which methods of measurement should be used? |
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| Time stamp (T) | Date of literature search or recommendation | 27 January 2016 |
| Study type | What is the most appropriate study design to address the proposed question? |
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| Antibiotics for irreversible pulpitis | ||||||
| Patient or population: Patients with irreversible pulpitis Control: Placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect | Number of participants | Quality of the evidence | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | Antibiotics | |||||
| Patient‐reported pain intensity | Study population | Not estimable | 40 | ⊕⊕⊝⊝ | The in‐between group differences in SPID and SPPID were not statistically significant2 | |
| Moderate | ||||||
| Patient‐reported pain relief ‐ not reported | See comment | See comment | Not estimable | ‐ | See comment | Not assessed |
| Total number of ibuprofen tablets | The mean total number of ibuprofen tablets in the control groups was | The mean total number of ibuprofen tablets in the intervention groups was | 40 | ⊕⊕⊝⊝ | The administration of penicillin over placebo did not appear to significantly reduce the quantity of ibuprofen consumed for irreversible pulpitis | |
| Total number of paracetamol (acetaminophen) + codeine tablets | The mean total number of acetaminophen + codeine tablets in the control groups was | The mean total number of acetaminophen + codeine tablets in the intervention groups was | 40 | ⊕⊕⊝⊝ | The administration of penicillin over placebo did not appear to significantly reduce the quantity of Tylenol consumed for irreversible pulpitis | |
| Number of adverse events ‐ not reported | See comment | See comment | Not estimable | ‐ | See comment | Not assessed |
| *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) | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Small sample size, unable to use data, assume imprecise estimate. | ||||||
| Penicillin | Placebo | |
| Initial pain (median & interquartile range) | 2.00 +/‐ 0.00 | 2.00 +/‐ 1.00 |
| Initial percussion pain (median & interquartile range) | 2.00 +/‐ 0.50 | 2.00 +/‐ 1.00 |
| Pain ratings: moderate | 65% | 80% |
| Pain ratings: severe | 35% | 20% |
| Percussion pain ratings: mild | 20% | 25% |
| Percussion pain ratings: moderate | 50% | 65% |
| Percussion pain ratings: severe | 30% | 10% |
| Penicillin | Placebo | P value | |
| Sum of pain intensity difference (median and interquartile range) | 6.0 +/‐ 10.5 | 6.0 +/‐ 9.5 | .776 |
| Sum of percussion pain intensity difference (median and interquartile range) | 3.5 +/‐7.5 | 2.0 +/‐ 7.0 | .290 |
| Day | n Ibuprofen | n Tylenol | Nil pain medication |
| DAY 1 | |||
| Penicillin | 17 (85%) | 10 (50%) | 1 (5%) |
| No of tablets | 33 | 21 | 0 |
| Placebo | 16 (80%) | 8 (40%) | 0 |
| No of tablets | 28 | 11 | 0 |
| DAY 2 | |||
| Penicillin | 17 (85%) | 10 (50%) | 0 |
| No of tablets | 30 | 28 | 0 |
| Placebo | 16 (80%) | 9 (45%) | 1 (5%) |
| No of tablets | 31 | 18 | 0 |
| DAY 3 | |||
| Penicillin | 13 (65%) | 9 (45%) | 4 (20%) |
| No of tablets | 27 | 20 | 0 |
| Placebo | 15 (75%) | 8 (40%) | 3 (15%) |
| No of tablets | 28 | 14 | 0 |
| DAY 4 | |||
| Penicillin | 12 (60%) | 9(45%) | 6 (30%) |
| No of tablets | 24 | 23 | 0 |
| Placebo | 17 (85%) | 5 (25%) | 2 (10%) |
| No of tablets | 28 | 8 | 0 |
| DAY 5 | |||
| Penicillin | 12 (60%) | 8 (40%) | 7 (35%) |
| No of tablets | 21 | 15 | 0 |
| Placebo | 16 (80%) | 7 (35%) | 3 (15%) |
| No of tablets | 32 | 11 | 0 |
| DAY 6 | |||
| Penicillin | 13 (65%) | 8 (40%) | 5 (25%) |
| No of tablets | 24 | 15 | 0 |
| Placebo | 13 (65%) | 6 (30%) | 6 (30%) |
| No of tablets | 24 | 13 | 0 |
| DAY 7 | |||
| Penicillin | 14 (70%) | 10 (50%) | 4 (20%) |
| No of tablets | 25 | 16 | 0 |
| Placebo | 11 (55%) | 7 (35%) | 7 (35%) |
| No of tablets | 20 | 14 | 0 |
