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Cochrane Database of Systematic Reviews

Antibióticos sistémicos para el tratamiento de las heridas neoplásicas

Información

DOI:
https://doi.org/10.1002/14651858.CD011609.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 24 agosto 2017see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Heridas

Copyright:
  1. Copyright © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

  • Darshini A Ramasubbu

    Correspondencia a: Dental Department, HSE, Dublin, Ireland

    [email protected]

    [email protected]

  • Valerie Smith

    School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland

  • Fiona Hayden

    Community Pharmacy, Lloyd’s Pharmacy, Dublin, Ireland

  • Patricia Cronin

    School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland

Contributions of authors

Darshini Ramasubbu: conceived, designed and coordinated the review; extracted data; checked the quality of data extraction; checked quality assessment; produced the first draft of the review; contributed to writing and editing the review; made an intellectual contribution to the review; performed previous work that was the foundation of the current review; wrote to study author/experts/companies; provided data; performed economic analysis; performed translations; approved the final review prior to submission and is a guarantor of the review.

Valerie Smith: conceived and designed the review; checked the quality of data extraction; analysed or interpreted data; undertook and checked quality assessment; performed statistical analysis; checked the quality of the statistical analysis; produced the first draft of the review; contributed to writing or editing the review; made an intellectual contribution to the review; advised on the review and approved the final review prior to submission.

Fiona Hayden: made an intellectual contribution to the review; advised on the review and approved the final review prior to submission.

Patricia Cronin: conceived, designed and coordinated the review; extracted data; checked the quality of data extraction; analysed or interpreted data; undertook quality assessment; performed statistical analysis; produced the first draft of the review; contributed to writing or editing the review; made an intellectual contribution to the review; performed previous work that was the foundation of the current review; wrote to study author/experts/companies and approved the final review prior to submission.

Contributions of editorial base:

Andrea Nelson (Editor): edited the protocol; advised on methodology interpretation and content; approved the final protocol prior to submission.

Gill Norman (Editor): edited the review; advised on methodology interpretation and content; approved the final review prior to submission.

Gill Rizzello and Sally Bell‐Syer (Managing Editors): co‐ordinated the editorial process; advised on interpretation and content; edited the protocol and the review.

Zipporah Iheozor‐Ejiofor (Methodologist): advised on methodology in the review.

Reetu Child and Naomi Shaw (Information Specialists): designed the search strategy, edited the search methods section and ran the searches for the review.

Ursula Gonthier (Editorial Assistant): edited the plain language summary and reference sections of the review.

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • This project was supported by the National Institute for Health Research (NIHR) via Cochrane Infrastructure funding to Cochrane Wounds. The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health, UK.

Declarations of interest

Darshini Ramasubbu: none known.

Valerie Smith: none known.

Fiona Hayden: none known.

Patricia Cronin: none known.

Acknowledgements

The review authors would like to thank Cochrane Wounds for their support in undertaking this review, copy editors Elizabeth Royle and Jason Elliot‐Smith for their helpful feedback, and the following peer referees for their comments: Julie Bruce, Jane Nadel (protocol and review); Andrew McKean (review); Mark Rodgers and Gill Worthy (protocol).

Version history

Published

Title

Stage

Authors

Version

2017 Aug 24

Systemic antibiotics for treating malignant wounds

Review

Darshini A Ramasubbu, Valerie Smith, Fiona Hayden, Patricia Cronin

https://doi.org/10.1002/14651858.CD011609.pub2

2015 Apr 07

Systemic antibiotics for treating malignant wounds

Protocol

Darshini A Ramasubbu, Valerie Smith, Fiona Hayden, Patricia Cronin

https://doi.org/10.1002/14651858.CD011609

Differences between protocol and review

We updated our search strategies adding terms for smelly and malodorous tumours.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Humans;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

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

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

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 3

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

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Forest plot of comparison: 1 Metronidazole versus Placebo, outcome: 1.1 Malodour (Smell Score).
Figuras y tablas -
Figure 4

Forest plot of comparison: 1 Metronidazole versus Placebo, outcome: 1.1 Malodour (Smell Score).

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Comparison 1 Metronidazole versus Placebo, Outcome 1 Malodour (Smell Score).
Figuras y tablas -
Analysis 1.1

Comparison 1 Metronidazole versus Placebo, Outcome 1 Malodour (Smell Score).

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Summary of findings for the main comparison. Metronidazole compared to Placebo for treating malignant wounds

Metronidazole compared to Placebo for treating malignant wounds

Patient or population: treating malignant wounds
Setting: hospital
Intervention: metronidazole
Comparison: placebo

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

№ of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with Placebo

Risk with Metronidazole

Malodour (smell score measured on a scale of 0 to 3 with higher scores indicating a more offensive smell)

The mean malodour (smell score) was 3.33 (range 2.0 to 4.0)

MD 2.16 lower
(3.60 to 0.72 lower)

‐

6
(1 RCT)

⊕⊝⊝⊝
very low 1

It is uncertain whether metronidazole leads to a reduction in malodour because the quality of the evidence is very low

Adverse effects

Study population

not estimable

6
(1 RCT)

NA

0 per 1000

0 per 1000
(0 to 0)

*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; RR: risk ratio; MD: mean difference.

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low quality: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

1 Downgraded 3 levels: serious limitation — insufficient details provided to make clear judgements on random sequence generation and allocation concealment. There was also a 33% loss to follow‐up; very serious imprecision; a small sample size of 6 participants.

2 Smell was independently assessed at each visit by the patient, doctor, and nurse, who graded the smell as "absent" (0), "not offensive" (1), "offensive but tolerable" (2), or "offensive and intolerable" (3), and an amalgamated score calculated.

Figuras y tablas -
Summary of findings for the main comparison. Metronidazole compared to Placebo for treating malignant wounds
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Comparison 1. Metronidazole versus Placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Malodour (Smell Score) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 1. Metronidazole versus Placebo
Ir a la tabla de la revisión