Cochrane · systematic review · CD004406
Different antibiotic treatments for group A streptococcal pharyngitis
Hedin, K, Thorning, S, van Driel, ML · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
17
current version
GRADE rated
17
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 7 · 41.2%Low 10 · 58.8%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyCephalosporins versus penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Cephalosporins vs penicillin | OR 0.79 [0.55, 1.12] | 5 studies · 2018 participants | Low Downgraded: risk of bias, imprecision |
Resolution of symptoms post‐treatment (evaluable participants) Cephalosporins vs penicillin | OR 0.51 [0.27, 0.97] | 5 studies · 1660 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Incidence of relapse (evaluable participants) Cephalosporins vs penicillin | OR 0.55 [0.3, 0.99] | 4 studies · 1386 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (ITT analysis) Cephalosporins vs penicillin | OR 0.94 [0.27, 3.25] | 3 studies · 1279 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Macrolides versus penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Macrolides vs penicillin | OR 1.11 [0.92, 1.35] | 6 studies · 1728 participants | Low Downgraded: imprecision |
Resolution of symptoms post‐treatment (evaluable participants) Macrolides vs penicillin | OR 0.79 [0.57, 1.09] | 6 studies · 1159 participants | Low Downgraded: imprecision |
Incidence of relapse (evaluable participants) Macrolides vs penicillin | OR 1.21 [0.48, 3.03] | 6 studies · 802 participants | Low Downgraded: imprecision |
Adverse events (ITT analysis) Macrolides vs penicillin | OR 1.19 [0.82, 1.73] | 6 studies · 1727 participants | Low Downgraded: imprecision |
Azithromycin versus amoxicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure (ITT analysis) Azithromycin vs amoxicillin | OR 0.76 [0.55, 1.05] | 1 study · 673 participants | Very low Downgraded: imprecision |
Clinical cure (bacteriological per protocol analysis) Azithromycin vs amoxicillin | OR 0.29 [0.11, 0.73] | 1 study · 482 participants | Very low Downgraded: imprecision |
Relapse (ITT analysis) Azithromycin vs amoxicillin | OR 0.75 [0.55, 1.02] | 1 study · 673 participants | Very low Downgraded: imprecision |
Relapse (bacteriological per protocol analysis) Azithromycin vs amoxicillin | OR 0.88 [0.43, 1.82] | 1 study · 422 participants | Very low Downgraded: imprecision |
Adverse events (ITT analysis) Azithromycin vs amoxicillin | OR 2.67 [1.78, 3.99] | 1 study · 673 participants | Very low Downgraded: imprecision |
Carbacephem versus penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Carbacephem vs penicillin | OR 0.7 [0.49, 0.99] | 3 studies · 795 participants | Low Downgraded: imprecision |
Resolution of symptoms post‐treatment (evaluable participants) Carbacephem vs penicillin | OR 0.62 [0.38, 1.01] | 3 studies · 602 participants | Low Downgraded: imprecision |
Incidence of relapse (evaluable participants) Carbacephem vs penicillin | OR 1.27 [0.64, 2.5] | 3 studies · 523 participants | Low Downgraded: imprecision |
Adverse events (ITT analysis) Carbacephem vs penicillin | OR 1.08 [0.75, 1.55] | 3 studies · 795 participants | Low Downgraded: imprecision |
Cephalosporins versus penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Cephalosporins vs penicillin | OR 0.79 [0.55, 1.12] | 5 studies · 2018 participants | Low Downgraded: risk of bias, imprecision |
Resolution of symptoms post‐treatment (evaluable participants) Cephalosporins vs penicillin | OR 0.51 [0.27, 0.97] | 5 studies · 1660 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Incidence of relapse (evaluable participants) Cephalosporins vs penicillin | OR 0.55 [0.3, 0.99] | 4 studies · 1386 participants | Low Downgraded: risk of bias, imprecision |
Adverse events (ITT analysis) Cephalosporins vs penicillin | OR 0.94 [0.27, 3.25] | 3 studies · 1279 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Macrolides versus penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Macrolides vs penicillin | OR 1.11 [0.92, 1.35] | 6 studies · 1728 participants | Low Downgraded: imprecision |
Resolution of symptoms post‐treatment (evaluable participants) Macrolides vs penicillin | OR 0.79 [0.57, 1.09] | 6 studies · 1159 participants | Low Downgraded: imprecision |
Incidence of relapse (evaluable participants) Macrolides vs penicillin | OR 1.21 [0.48, 3.03] | 6 studies · 802 participants | Low Downgraded: imprecision |
Adverse events (ITT analysis) Macrolides vs penicillin | OR 1.19 [0.82, 1.73] | 6 studies · 1727 participants | Low Downgraded: imprecision |
Azithromycin versus amoxicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical cure (ITT analysis) Azithromycin vs amoxicillin | OR 0.76 [0.55, 1.05] | 1 study · 673 participants | Very low Downgraded: imprecision |
Clinical cure (bacteriological per protocol analysis) Azithromycin vs amoxicillin | OR 0.29 [0.11, 0.73] | 1 study · 482 participants | Very low Downgraded: imprecision |
Relapse (ITT analysis) Azithromycin vs amoxicillin | OR 0.75 [0.55, 1.02] | 1 study · 673 participants | Very low Downgraded: imprecision |
Relapse (bacteriological per protocol analysis) Azithromycin vs amoxicillin | OR 0.88 [0.43, 1.82] | 1 study · 422 participants | Very low Downgraded: imprecision |
Adverse events (ITT analysis) Azithromycin vs amoxicillin | OR 2.67 [1.78, 3.99] | 1 study · 673 participants | Very low Downgraded: imprecision |
Carbacephem versus penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Carbacephem vs penicillin | OR 0.7 [0.49, 0.99] | 3 studies · 795 participants | Low Downgraded: imprecision |
Resolution of symptoms post‐treatment (evaluable participants) Carbacephem vs penicillin | OR 0.62 [0.38, 1.01] | 3 studies · 602 participants | Low Downgraded: imprecision |
Incidence of relapse (evaluable participants) Carbacephem vs penicillin | OR 1.27 [0.64, 2.5] | 3 studies · 523 participants | Low Downgraded: imprecision |
Adverse events (ITT analysis) Carbacephem vs penicillin | OR 1.08 [0.75, 1.55] | 3 studies · 795 participants | Low Downgraded: imprecision |
Cephalosporins compared to penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Cephalosporins vs penicillin | OR 0.79 [0.55, 1.12] | 5 studies · 2018 participants | Low Downgraded: risk of bias |
Resolution of symptoms post‐treatment (ITT analysis) ‐ Adults Cephalosporins vs penicillin | OR 0.78 [0.6, 1.01] | 2 studies · 1163 participants | Low Downgraded: risk of bias |
Resolution of symptoms post‐treatment (ITT analysis) ‐ Children Cephalosporins vs penicillin | OR 0.83 [0.4, 1.73] | 3 studies · 855 participants | Very low Downgraded: risk of bias |
Resolution of symptoms post‐treatment (evaluable participants) Cephalosporins vs penicillin | OR 0.51 [0.27, 0.97] | 5 studies · 1660 participants | Very low Downgraded: risk of bias |
Incidence of relapse (evaluable participants) Cephalosporins vs penicillin | OR 0.55 [0.3, 0.99] | 4 studies · 1386 participants | Low Downgraded: risk of bias |
Adverse events (ITT analysis) Cephalosporins vs penicillin | OR 0.94 [0.27, 3.25] | 3 studies · 1279 participants | Very low Downgraded: risk of bias |
Macrolides compared to penicillin for group A streptococcal pharyngitis
Population: group A streptococcal pharyngitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Resolution of symptoms post‐treatment (ITT analysis) Macrolides vs penicillin | OR 1.11 [0.92, 1.35] | 6 studies · 1728 participants | Low Downgraded: imprecision |
Resolution of symptoms post‐treatment (evaluable participants only) Macrolides vs penicillin | OR 0.79 [0.57, 1.09] | 6 studies · 1159 participants | Low Downgraded: imprecision |
Incidence of relapse (evaluable participants) Macrolides vs penicillin | OR 1.21 [0.48, 3.03] | 6 studies · 802 participants | Low Downgraded: imprecision |
Adverse events (ITT analysis) Macrolides vs penicillin | OR 1.19 [0.82, 1.73] | 6 studies · 1727 participants | Low Downgraded: imprecision |