Cochrane · intervention · CD004969
Antibiotic use for irreversible pulpitis
Agnihotry, A, Thompson, W, Fedorowicz, Z, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
5
current version
GRADE rated
3
No studies
2
Included studies
1
as reported
No studies 2 · 40%Ungraded 0 · 0%Very low 0 · 0%Low 3 · 60%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.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis (traumatised teeth excluded) | Forty adult patients (17 male, 23 female), age range 30 to 34 years, presenting as an emergency with spontaneous moderate to severe pain associated with a tooth (n=40) |
| Intervention | Administration of any systemic antibiotic at any dosage plus any analgesic at any dosage in the acute preoperative phase of irreversible pulpitis | Penicillin 500 mg plus analgesics (ibuprofen 600 mg; acetaminophen with codeine 30 mg) (n=20) |
| Comparison | Administration of placebo plus any analgesic at any dosage in the acute preoperative phase of irreversible pulpitis | Placebo plus analgesics (n=20) |
| Outcomes | Patient-reported pain (intensity/duration) and pain relief on a categorical scale; Type, dose and frequency of medication required for pain relief; Any adverse effects related to hypersensitivity or other reactions to antibiotics or analgesics | Patient-reported pain intensity SPID and SPPID (n=40); Patient-reported pain relief (not reported); Total ibuprofen tablets (n=40); Total paracetamol + codeine tablets (n=40); Number of adverse events (not reported) |
| Study designs | Randomised controlled trials (RCTs) | Randomised double-blind placebo-controlled trial (n=1) |
| Timing | Acute preoperative phase (pre-endodontic treatment) | 7-day follow-up (n=1) |
Search date: 2019-02. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; ClinicalTrials.gov; WHO International Clinical Trials Registry Platform
Questions and results
Show all 5 versionsSystemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic
Population: Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Total number of ibuprofen tablets 7 days | MD -0.40 [-4.23, 3.43] -0.40 [-4.23, 3.43] tablets | 1 study · 40 participants | Low Downgraded: imprecision |
Number of adverse events | Number of adverse events: Outcome not reported. | NR | No studies |
Patient-reported pain intensity (sum of pain intensity difference (SPID) and sum of pain percussion intensity difference (SPPID)) 7 days | Corresponding risk (Antibiotics): The in between-group differences (median +/- IQR) in SPID for the penicillin group were 6.0 +/- 10.5, and for placebo 6.0 +/- 9.5. The SPPID for the penicillin group was 3.5 +/- 7.5… | 1 study · 40 participants | Low Downgraded: imprecision |
Total number of paracetamol (acetaminophen) with codeine (Tylenol) tablets 7 days | MD 2.45 [-1.23, 6.13] 2.45 [-1.23, 6.13] tablets | 1 study · 40 participants | Low Downgraded: imprecision |
Patient-reported pain relief | Patient-reported pain relief: Outcome not reported. | NR | No studies |