What do systematic reviews say?

Tacrolimus vs cyclosporin

Tacrolimus showed no clear difference in treatment response at 12 months: complete remission compared with cyclosporin (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.8 [0.45, 1.42]
  2 studies · 58 participants
  Low

Tacrolimus vs cyclosporin

Tacrolimus showed no clear difference in adverse events: persistent nephrotoxicity compared with cyclosporin (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.48 [0.05, 4.85]
  1 study · 41 participants
  Low

Tacrolimus vs cyclosporin

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 58 participants
  Low

Tacrolimus vs mycophenolate mofetil to maintain remission

Tacrolimus may leads to higher number with complete or partial response at one year compared with mycophenolate mofetil to maintain remission (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 2.01 [1.32, 3.07]
  1 study · 60 participants
  Low

Tacrolimus vs mycophenolate mofetil to maintain remission

Tacrolimus may leads to higher number with complete response at one year compared with mycophenolate mofetil to maintain remission (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 1.79 [1.11, 2.9]
  1 study · 60 participants
  Low

Tacrolimus vs mycophenolate mofetil to maintain remission

Tacrolimus showed no clear difference in number with partial response at one year compared with mycophenolate mofetil to maintain remission (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 4.68 [0.58, 37.68]
  1 study · 60 participants
  Low

Tacrolimus vs mycophenolate mofetil to maintain remission

Tacrolimus may leads to lower number with treatment failure by one year compared with mycophenolate mofetil to maintain remission (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.18 [0.06, 0.54]
  1 study · 60 participants
  Low

Tacrolimus vs mycophenolate mofetil to maintain remission

Tacrolimus may leads to lower number with frequent relapses by one year compared with mycophenolate mofetil to maintain remission (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.28 [0.09, 0.92]
  1 study · 60 participants
  Low

Tacrolimus vs mycophenolate mofetil to maintain remission

Tacrolimus showed no clear difference in number with steroid resistance by one year compared with mycophenolate mofetil to maintain remission (low certainty).

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  RR 0.07 [0, 1.23]
  1 study · 60 participants
  Low

Tacrolimus vs mycophenolate mofetil to maintain remission

• Interventions for idiopathic steroid‐resistant nephrotic syndrome in children 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 60 participants
  Low

Macrolides vs doxycycline

• Antibiotics for treating scrub typhus 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 242 participants
  Very low

Macrolides vs doxycycline

It is very uncertain whether macrolides changes treatment failure compared with doxycycline (very low certainty).

• Antibiotics for treating scrub typhus 2018 · Cochrane Headline outcomes only
  RR 2.71 [0.12, 63.84]
  3 studies · 242 participants
  Very low

Macrolides vs doxycycline

It is very uncertain whether macrolides changes resolution of fever within 48 hours compared with doxycycline (very low certainty).

• Antibiotics for treating scrub typhus 2018 · Cochrane Headline outcomes only
  RR 0.81 [0.32, 2.03]
  2 studies · 150 participants
  Very low

Macrolides vs doxycycline

Macrolides showed no clear difference in resolution of fever within 5 days compared with doxycycline (low certainty).

• Antibiotics for treating scrub typhus 2018 · Cochrane Headline outcomes only
  RR 1.05 [0.99, 1.1]
  2 studies · 185 participants
  Low

Macrolides vs doxycycline

• Antibiotics for treating scrub typhus 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 242 participants
  Very low

Gastrointestinal adverse events in people taking macrolide antibiotics vs placebo

Gastrointestinal adverse events in people taking macrolide antibiotics probably leads to higher gastrointestinal disorders not otherwise specified compared with placebo (moderate certainty).

• Adverse events in people taking macrolide antibiotics versus placebo for any indication 2019 · Cochrane Headline outcomes only
  OR 2.16 [1.56, 3]
  23 studies · 3295 participants
  Moderate

Gastrointestinal adverse events in people taking macrolide antibiotics vs placebo

Gastrointestinal adverse events in people taking macrolide antibiotics may leads to higher abdominal pain compared with placebo (low certainty).

• Adverse events in people taking macrolide antibiotics versus placebo for any indication 2019 · Cochrane Headline outcomes only
  OR 1.66 [1.22, 2.26]
  23 studies · 7776 participants
  Low

Gastrointestinal adverse events in people taking macrolide antibiotics vs placebo

Gastrointestinal adverse events in people taking macrolide antibiotics may leads to higher diarrhoea compared with placebo (low certainty).

• Adverse events in people taking macrolide antibiotics versus placebo for any indication 2019 · Cochrane Headline outcomes only
  OR 1.7 [1.34, 2.16]
  37 studies · 23754 participants
  Low

Gastrointestinal adverse events in people taking macrolide antibiotics vs placebo

Gastrointestinal adverse events in people taking macrolide antibiotics probably leads to higher nausea compared with placebo (moderate certainty).

• Adverse events in people taking macrolide antibiotics versus placebo for any indication 2019 · Cochrane Headline outcomes only
  OR 1.61 [1.37, 1.9]
  28 studies · 14983 participants
  Moderate

Gastrointestinal adverse events in people taking macrolide antibiotics vs placebo

Gastrointestinal adverse events in people taking macrolide antibiotics probably leads to higher vomiting compared with placebo (moderate certainty).

• Adverse events in people taking macrolide antibiotics versus placebo for any indication 2019 · Cochrane Headline outcomes only
  OR 1.27 [1.04, 1.56]
  15 studies · 5328 participants
  Moderate