Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review
Background: The management of acute respiratory infections (ARIs), urinary tract infections (UTIs), and skin and soft tissue infections (SSTIs) should be guided by high quality evidence. Aim: To compare the quantity and quality of randomised placebo-controlled trials of antibiotics for ARIs, UTIs, a...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2020-09-01
|
| Series: | BJGP Open |
| Subjects: | |
| Online Access: | https://bjgpopen.org/content/4/4/bjgpopen20X101082 |
| _version_ | 1818326029141278720 |
|---|---|
| author | Mina Bakhit Tammy Hoffmann Miriam Santer Matthew Ridd Nick Francis Eva Hummers Justin Clark Carmen Hilliges Chris Del Mar |
| author_facet | Mina Bakhit Tammy Hoffmann Miriam Santer Matthew Ridd Nick Francis Eva Hummers Justin Clark Carmen Hilliges Chris Del Mar |
| author_sort | Mina Bakhit |
| collection | DOAJ |
| description | Background: The management of acute respiratory infections (ARIs), urinary tract infections (UTIs), and skin and soft tissue infections (SSTIs) should be guided by high quality evidence. Aim: To compare the quantity and quality of randomised placebo-controlled trials of antibiotics for ARIs, UTIs, and SSTIs. Design & setting: A scoping review of the literature was performed using comprehensive search strategies. Method: PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for published studies from inception until 17 April 2019. Randomised controlled trials (RCTs) that compared participants in primary care or in the community who had uncomplicated acute ARI, UTI, or studies, and were randomised to antibiotic or placebo (or no active treatment), were eligible for inclusion. Two groups of researchers independently screened articles for inclusion, extracted data, and assessed the quality of included studies. Results: A total of 108 eligible studies were identified: 80 on ARI, eight on UTI, and 20 on SSTI. The quality of studies varied with unclear risk of bias (RoB) prevalent in many domains. There was a gradual improvement in the quality of trials investigating ARIs over time, which could not be assessed in SSTI and UTI studies. Conclusion: This review highlights a sparsity of trials assessing the effectiveness of antibiotics in people with UTIs and SSTIs, compared to trials targeting ARIs. This gap in the evidence needs to be addressed by conducting further high quality trials on the effects of antibiotics in patients with UTI and SSTI. |
| first_indexed | 2024-12-13T11:53:52Z |
| format | Article |
| id | doaj.art-73578114a0724b0a92ea6e3defa5ce2c |
| institution | Directory Open Access Journal |
| issn | 2398-3795 |
| language | English |
| last_indexed | 2024-12-13T11:53:52Z |
| publishDate | 2020-09-01 |
| publisher | Royal College of General Practitioners |
| record_format | Article |
| series | BJGP Open |
| spelling | doaj.art-73578114a0724b0a92ea6e3defa5ce2c2022-12-21T23:47:16ZengRoyal College of General PractitionersBJGP Open2398-37952020-09-014410.3399/bjgpopen20X101082Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping reviewMina Bakhit0Tammy Hoffmann1Miriam Santer2Matthew Ridd3Nick Francis4Eva Hummers5Justin Clark6Carmen Hilliges7Chris Del Mar8Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, AustraliaInstitute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, AustraliaPrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UKPopulation Health Sciences, University of Bristol, Bristol, UKPrimary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UKDepartment of General Practice, Göttingen University Medical Centre, Göttingen, GermanyInstitute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, AustraliaDepartment of General Practice, Göttingen University Medical Centre, Göttingen, GermanyInstitute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, AustraliaBackground: The management of acute respiratory infections (ARIs), urinary tract infections (UTIs), and skin and soft tissue infections (SSTIs) should be guided by high quality evidence. Aim: To compare the quantity and quality of randomised placebo-controlled trials of antibiotics for ARIs, UTIs, and SSTIs. Design & setting: A scoping review of the literature was performed using comprehensive search strategies. Method: PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for published studies from inception until 17 April 2019. Randomised controlled trials (RCTs) that compared participants in primary care or in the community who had uncomplicated acute ARI, UTI, or studies, and were randomised to antibiotic or placebo (or no active treatment), were eligible for inclusion. Two groups of researchers independently screened articles for inclusion, extracted data, and assessed the quality of included studies. Results: A total of 108 eligible studies were identified: 80 on ARI, eight on UTI, and 20 on SSTI. The quality of studies varied with unclear risk of bias (RoB) prevalent in many domains. There was a gradual improvement in the quality of trials investigating ARIs over time, which could not be assessed in SSTI and UTI studies. Conclusion: This review highlights a sparsity of trials assessing the effectiveness of antibiotics in people with UTIs and SSTIs, compared to trials targeting ARIs. This gap in the evidence needs to be addressed by conducting further high quality trials on the effects of antibiotics in patients with UTI and SSTI.https://bjgpopen.org/content/4/4/bjgpopen20X101082anti-bacterial agentprimary health carerespiratory tract infectionsurinary tract infectionsskin and soft tissues infectionsrandomised controlled trials |
| spellingShingle | Mina Bakhit Tammy Hoffmann Miriam Santer Matthew Ridd Nick Francis Eva Hummers Justin Clark Carmen Hilliges Chris Del Mar Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review BJGP Open anti-bacterial agent primary health care respiratory tract infections urinary tract infections skin and soft tissues infections randomised controlled trials |
| title | Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review |
| title_full | Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review |
| title_fullStr | Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review |
| title_full_unstemmed | Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review |
| title_short | Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review |
| title_sort | comparing the quantity and quality of randomised placebo controlled trials of antibiotics for acute respiratory urinary and skin and soft tissue infections a scoping review |
| topic | anti-bacterial agent primary health care respiratory tract infections urinary tract infections skin and soft tissues infections randomised controlled trials |
| url | https://bjgpopen.org/content/4/4/bjgpopen20X101082 |
| work_keys_str_mv | AT minabakhit comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT tammyhoffmann comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT miriamsanter comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT matthewridd comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT nickfrancis comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT evahummers comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT justinclark comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT carmenhilliges comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview AT chrisdelmar comparingthequantityandqualityofrandomisedplacebocontrolledtrialsofantibioticsforacuterespiratoryurinaryandskinandsofttissueinfectionsascopingreview |