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Mieke L Van Driel - One of the best experts on this subject based on the ideXlab platform.
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antibiotics for preventing recurrent Sore Throat
Cochrane Database of Systematic Reviews, 2015Co-Authors: Stephanie Tan, Chris B Del Mar, Mieke L Van DrielAbstract:Background: Antibiotics are sometimes used to prevent recurrent Sore Throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness. Objectives: To assess the effects of antibiotics in patients with recurrent Sore Throat. Search methods: The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015. Selection criteria: Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent Sore Throat, defined as three or more Sore Throats in a year, examining the incidence of Sore Throat recurrence, with follow-up of at least 12 months post-antibiotic therapy. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response. Main results: We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report. Authors' conclusions: There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent Sore Throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent Sore Throat on the following outcomes: incidence of Sore Throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
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The Cochrane Library - Antibiotics for preventing recurrent Sore Throat
The Cochrane database of systematic reviews, 2015Co-Authors: Stephanie Tan, Chris Del Mar, Mieke L Van DrielAbstract:Background: Antibiotics are sometimes used to prevent recurrent Sore Throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness. Objectives: To assess the effects of antibiotics in patients with recurrent Sore Throat. Search methods: The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015. Selection criteria: Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent Sore Throat, defined as three or more Sore Throats in a year, examining the incidence of Sore Throat recurrence, with follow-up of at least 12 months post-antibiotic therapy. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response. Main results: We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report. Authors' conclusions: There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent Sore Throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent Sore Throat on the following outcomes: incidence of Sore Throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
Stephanie Tan - One of the best experts on this subject based on the ideXlab platform.
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antibiotics for preventing recurrent Sore Throat
Cochrane Database of Systematic Reviews, 2015Co-Authors: Stephanie Tan, Chris B Del Mar, Mieke L Van DrielAbstract:Background: Antibiotics are sometimes used to prevent recurrent Sore Throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness. Objectives: To assess the effects of antibiotics in patients with recurrent Sore Throat. Search methods: The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015. Selection criteria: Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent Sore Throat, defined as three or more Sore Throats in a year, examining the incidence of Sore Throat recurrence, with follow-up of at least 12 months post-antibiotic therapy. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response. Main results: We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report. Authors' conclusions: There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent Sore Throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent Sore Throat on the following outcomes: incidence of Sore Throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
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The Cochrane Library - Antibiotics for preventing recurrent Sore Throat
The Cochrane database of systematic reviews, 2015Co-Authors: Stephanie Tan, Chris Del Mar, Mieke L Van DrielAbstract:Background: Antibiotics are sometimes used to prevent recurrent Sore Throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness. Objectives: To assess the effects of antibiotics in patients with recurrent Sore Throat. Search methods: The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015. Selection criteria: Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent Sore Throat, defined as three or more Sore Throats in a year, examining the incidence of Sore Throat recurrence, with follow-up of at least 12 months post-antibiotic therapy. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response. Main results: We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report. Authors' conclusions: There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent Sore Throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent Sore Throat on the following outcomes: incidence of Sore Throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
Chris B Del Mar - One of the best experts on this subject based on the ideXlab platform.
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antibiotics for preventing recurrent Sore Throat
Cochrane Database of Systematic Reviews, 2015Co-Authors: Stephanie Tan, Chris B Del Mar, Mieke L Van DrielAbstract:Background: Antibiotics are sometimes used to prevent recurrent Sore Throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness. Objectives: To assess the effects of antibiotics in patients with recurrent Sore Throat. Search methods: The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015. Selection criteria: Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent Sore Throat, defined as three or more Sore Throats in a year, examining the incidence of Sore Throat recurrence, with follow-up of at least 12 months post-antibiotic therapy. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response. Main results: We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report. Authors' conclusions: There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent Sore Throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent Sore Throat on the following outcomes: incidence of Sore Throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
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Antibiotics for Sore Throat.
The Cochrane database of systematic reviews, 2013Co-Authors: Anneliese Spinks, Paul P Glasziou, Chris B Del MarAbstract:Sore Throat is a common reason for people to present for medical care. Although it remits spontaneously, primary care doctors commonly prescribe antibiotics for it. To assess the benefits of antibiotics for Sore Throat for patients in primary care settings. We searched CENTRAL 2013, Issue 6, MEDLINE (January 1966 to July week 1, 2013) and EMBASE (January 1990 to July 2013). Randomised controlled trials (RCTs) or quasi-RCTs of antibiotics versus control assessing typical Sore Throat symptoms or complications. Two review authors independently screened studies for inclusion and extracted data. We resolved differences in opinion by discussion. We contacted trial authors from three studies for additional information. We included 27 trials with 12,835 cases of Sore Throat. We did not identify any new trials in this 2013 update. 1. Symptoms Throat Soreness and fever were reduced by about half by using antibiotics. The greatest difference was seen at day three. The number needed to treat to benefit (NNTB) to prevent one Sore Throat at day three was less than six; at week one it was 21. 2. Non-suppurative complications The trend was antibiotics protecting against acute glomerulonephritis but there were too few cases to be sure. Several studies found antibiotics reduced acute rheumatic fever by more than two-thirds within one month (risk ratio (RR) 0.27; 95% confidence interval (CI) 0.12 to 0.60). 3. Suppurative complications Antibiotics reduced the incidence of acute otitis media within 14 days (RR 0.30; 95% CI 0.15 to 0.58); acute sinusitis within 14 days (RR 0.48; 95% CI 0.08 to 2.76); and quinsy within two months (RR 0.15; 95% CI 0.05 to 0.47) compared to those taking placebo. 4. Subgroup analyses of symptom reduction Antibiotics were more effective against symptoms at day three (RR 0.58; 95% CI 0.48 to 0.71) if Throat swabs were positive for Streptococcus, compared to RR 0.78; 95% CI 0.63 to 0.97 if negative. Similarly at week one the RR was 0.29 (95% CI 0.12 to 0.70) for positive and 0.73 (95% CI 0.50 to 1.07) for negative Streptococcus swabs. Antibiotics confer relative benefits in the treatment of Sore Throat. However, the absolute benefits are modest. Protecting Sore Throat sufferers against suppurative and non-suppurative complications in high-income countries requires treating many with antibiotics for one to benefit. This NNTB may be lower in low-income countries. Antibiotics shorten the duration of symptoms by about 16 hours overall.
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antibiotics for Sore Throat
Cochrane Database of Systematic Reviews, 2013Co-Authors: Anneliese Spinks, Paul P Glasziou, Chris B Del MarAbstract:BACKGROUND: Sore Throat is a very common reason for people to seek medical care. It is a disease that remits spontaneously, that is, 'cure' is not dependent on treatment. Nonetheless primary care doctors commonly prescribe antibiotics for Sore Throat and other upper respiratory tract infections. OBJECTIVES: To assess the benefits of antibiotics in the management of Sore Throat. SEARCH STRATEGY: Systematic search of the literature from 1945 to 2003, using electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, issue 2, 2003); MEDLINE (January 1966 to May 2003); EMBASE (January 1990 to March 2003), and the reference sections of the articles identified. We applied no language restrictions. We used abstracts of identified articles to identify trials. SELECTION CRITERIA: Trials of antibiotic against control with either measures of the typical symptoms (Throat Soreness, headache or fever), or suppurative complications (meaning: forming pus) and non-suppurative complications of Sore Throat. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened potential studies for inclusion and resolved differences in opinion by discussion. The reviewers then independently extracted the data from the selected studies. We contacted the authors of three studies to acquire additional information not available in published articles.Potential studies were screened independently by two reviewers for inclusion, with differences in opinion resolved by discussion. Data was then independently extracted from studies selected by inclusion by two reviewers. Authors of three studies were contacted to acquire additional information not available in published articles. MAIN RESULTS: We included twenty-six studies, covering 12,669 cases of Sore Throat in the review.1. Non-suppurative complications There was a trend for protection against acute glomerulonephritis by antibiotics, but insufficient cases were recorded to be sure of this effect. Several studies found that antibiotics reduced acute rheumatic fever, to less than one third (odds ratio (OR) = 0.30; 95% confidence interval (CI) = 0.20 to 0.45). 2. Suppurative complications Antibiotics reduced the incidence of acute otitis media to about one quarter of that in the placebo group (OR = 0.22; 95% CI 0.11 to 0.43) and reduced the incidence of acute sinusitis to about one half of that in the placebo group (OR = 0.46; 95% CI 0.10 to 2.05). The incidence of quinsy was also reduced in relation to placebo group (OR = 0.16; 95% CI 0.07 to 0.35). 3. Symptoms Symptoms of headache, Throat Soreness and fever were reduced by antibiotics to about one half. The greatest time for this to be evident was at about three and a half days (when the symptoms of about 50% of untreated patients had settled). About 90% of treated and untreated patients were free of symptoms by one week. The overall number needed to treat to prevent one Sore Throat at day three was about 5.0 (95% CI 4.5 to 5.8); and at one week was 14.2 (95% CI 11.5 to 20.6). 4. Subgroup analyses of symptom reduction Subgroup analysis by age; blind versus unblinded; or use of antipyretics yielded no significant differences. The results of swabs of the Throat for Streptococcus influenced the effect of antibiotics. If the swab was positive, antibiotics were more effective (the OR reduced to 0.16, 95% CI 0.09 to 0.26) than if it was negative (OR 0.65; 95% CI 0.38 to 1.12). REVIEWERS' CONCLUSIONS: Antibiotics confer relative benefits in the treatment of Sore Throat. However, the absolute benefits are modest. Protecting Sore Throat sufferers against suppurative and non-suppurative complications in modern Western society can be achieved only by treating with antibiotics many who will derive no benefit. In emerging economies where rates of for example acute rheumatic fever are high, the number needed to treat may be much lower. Antibiotics shorten the duration of symptoms by a mean of one day about half way through the illness (the time of maximal effect), and by about sixteen hours overall.
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Antibiotics for Sore Throat.
The Cochrane database of systematic reviews, 2004Co-Authors: Chris B Del Mar, Paul P Glasziou, A B SpinksAbstract:Sore Throat is a very common reason for people to seek medical care. It is a disease that remits spontaneously, that is, 'cure' is not dependent on treatment. Nonetheless primary care doctors commonly prescribe antibiotics for Sore Throat and other upper respiratory tract infections. To assess the benefits of antibiotics in the management of Sore Throat. Systematic search of the literature from 1945 to 2003, using electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, issue 2, 2003); MEDLINE (January 1966 to May 2003); EMBASE (January 1990 to March 2003), and the reference sections of the articles identified. We applied no language restrictions. We used abstracts of identified articles to identify trials. Trials of antibiotic against control with either measures of the typical symptoms (Throat Soreness, headache or fever), or suppurative complications (meaning: forming pus) and non-suppurative complications of Sore Throat. Two reviewers independently screened potential studies for inclusion and resolved differences in opinion by discussion. The reviewers then independently extracted the data from the selected studies. We contacted the authors of three studies to acquire additional information not available in published articles. Potential studies were screened independently by two reviewers for inclusion, with differences in opinion resolved by discussion. Data was then independently extracted from studies selected by inclusion by two reviewers. Authors of three studies were contacted to acquire additional information not available in published articles. We included twenty-six studies, covering 12,669 cases of Sore Throat in the review.1. Non-suppurative complications There was a trend for protection against acute glomerulonephritis by antibiotics, but insufficient cases were recorded to be sure of this effect. Several studies found that antibiotics reduced acute rheumatic fever, to less than one third (odds ratio (OR) = 0.30; 95% confidence interval (CI) = 0.20 to 0.45). 2. Suppurative complications Antibiotics reduced the incidence of acute otitis media to about one quarter of that in the placebo group (OR = 0.22; 95% CI 0.11 to 0.43) and reduced the incidence of acute sinusitis to about one half of that in the placebo group (OR = 0.46; 95% CI 0.10 to 2.05). The incidence of quinsy was also reduced in relation to placebo group (OR = 0.16; 95% CI 0.07 to 0.35). 3. Symptoms Symptoms of headache, Throat Soreness and fever were reduced by antibiotics to about one half. The greatest time for this to be evident was at about three and a half days (when the symptoms of about 50% of untreated patients had settled). About 90% of treated and untreated patients were free of symptoms by one week. The overall number needed to treat to prevent one Sore Throat at day three was about 5.0 (95% CI 4.5 to 5.8); and at one week was 14.2 (95% CI 11.5 to 20.6). 4. Subgroup analyses of symptom reduction Subgroup analysis by age; blind versus unblinded; or use of antipyretics yielded no significant differences. The results of swabs of the Throat for Streptococcus influenced the effect of antibiotics. If the swab was positive, antibiotics were more effective (the OR reduced to 0.16, 95% CI 0.09 to 0.26) than if it was negative (OR 0.65; 95% CI 0.38 to 1.12). Antibiotics confer relative benefits in the treatment of Sore Throat. However, the absolute benefits are modest. Protecting Sore Throat sufferers against suppurative and non-suppurative complications in modern Western society can be achieved only by treating with antibiotics many who will derive no benefit. In emerging economies where rates of for example acute rheumatic fever are high, the number needed to treat may be much lower. Antibiotics shorten the duration of symptoms by a mean of one day about half way through the illness (the time of maximal effect), and by about sixteen hours overall.
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how effective are treatments other than antibiotics for acute Sore Throat
British Journal of General Practice, 2000Co-Authors: M Thomas, Chris B Del Mar, Paul P GlasziouAbstract:To estimate the benefits of treatments other than antibiotics for acute Sore Throat, and the differences between non-antibiotic interventions and controls in patient-perceived pain of Sore Throat, a systematic review of controlled trials in Medline and the Cochrane Library was carried out. Sixty-six randomised controlled trials (with or without additional antibiotics) were identified and 17 met the selection criteria. Twenty-two non-antibiotic managements for Sore Throat were compared. Their efficacy relative to placebo ranged from no effect to 93%. Some non-antibiotic treatments may be more effective than antibiotics; however, publication bias may have exaggerated the benefits. These treatments should be investigated further with respect to efficacy, safety, and side-effects as potential firstline management options for acute Sore Throat.
Yuki Sato - One of the best experts on this subject based on the ideXlab platform.
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lidocaine for preventing postoperative Sore Throat
Cochrane Database of Systematic Reviews, 2015Co-Authors: Yuu Tanaka, Takeo Nakayama, Mina Nishimori, Yuka Tsujimura, Masahiko Kawaguchi, Yuki SatoAbstract:Background Sore Throat is a common side-effect of general anaesthesia and is reported by between 30% and 70% of patients after tracheal intubation. The likelihood of a Sore Throat varies with the type, diameter, and cuff pressure of the endotracheal tube used. If intubation is essential, it may be helpful to give drugs prophylactically to alleviate postoperative Sore Throat. Local anaesthetics and steroids have been used for this purpose. This review was originally published in 2009 and was updated in 2015. Objectives The objective of this review was to evaluate the efficacy and any harm caused by topical and systemic lidocaine used prophylactically to prevent postoperative Sore Throat in adults undergoing general anaesthesia with endotracheal intubation. Search methods We searched CENTRAL (The Cochrane Library 2013, Issue 9), MEDLINE (January 1966 to October 2013), and EMBASE (1980 to October 2013). We also contacted manufacturers and researchers in the field. The original search was undertaken in June 2007. We reran the search in February 2015 and found four studies of interest. We will deal with those studies when we next update the review. Selection criteria We included randomized controlled trials (RCTs) of topical and systemic prophylactic lidocaine therapy versus control (using air or saline) that reported on the risk and severity of postoperative Sore Throat as an outcome. Data collection and analysis Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information, such as the risk of any adverse effects. Main results We included 19 studies involving 1940 participants in this updated review. Of those 1940 participants, 952 received topical or systemic lidocaine therapy and 795 were allocated to the control groups. Topical and systemic lidocaine therapy appeared to reduce the risk of postoperative Sore Throat (16 studies, 1774 participants, risk ratio (RR) was 0.64 (95% confidence interval (CI) 0.48 to 0.85), the quality of the evidence was low), although when only high-quality trials were included (eight studies, 814 participants) the effect was no longer significant (RR 0.71, 95% CI 0.47 to 1.09). Lidocaine given systemically in two studies (320 participants) did not reveal evidence of an effect (RR 0.44, 95% CI 0.19 to 1.05 ). The severity of Sore Throat as measured on a visual-analogue scale (VAS) was reduced by lidocaine therapy (six trials, 611 participants, (mean difference (MD) -10.80, 95% CI -14.63 to -6.98). The adverse effects of lidocaine were not reported in these studies, though toxicity is generally rare. Authors' conclusions In our revised systematic review, although the results of included studies show generally positive results, they should be interpreted carefully. The effect size of lidocaine appeared to be affected by study quality; drug concentration; route of administration; management of cuff pressure during anaesthesia; the included population; and the type of outcome measured.
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Lidocaine for preventing postoperative Sore Throat.
The Cochrane database of systematic reviews, 2009Co-Authors: Yuu Tanaka, Takeo Nakayama, Mina Nishimori, Yuki Sato, Hitoshi FuruyaAbstract:Sore Throat is a common side effect of general anaesthesia and is reported by between 30% and 70% of patients after tracheal intubation. The likelihood of a Sore Throat varies with the type, diameter, and cuff pressure of the endotracheal tube used. If intubation is essential, it may be helpful to give drugs prophylactically to alleviate postoperative Sore Throat. Local anaesthetics and steroids have been used for this purpose. The objective of this review was to evaluate the effectiveness and any harms of topical and systematic lidocaine for the prevention of postoperative Sore Throat in adults undergoing endotracheal intubation as part of general anaesthesia. We searched CENTRAL (The Cochrane Library 2007, Issue 3), MEDLINE (January 1966 to June 2007), and EMBASE (1980 to June 2007). We also contacted manufacturers and researchers in the field. We included randomized controlled trials of topical and systemic prophylactic lidocaine therapy versus control (using air or saline) that reported on the risk and severity of postoperative Sore Throat as an outcome. Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information, such as the risk of adverse effects. We included 1232 patients from 15 studies; 672 patients received topical or systemic lidocaine therapy and 560 patients were allocated to the control group. Both the topical and systemic lidocaine therapy significantly reduced the risk of postoperative Sore Throat (risk ratio (RR) 0.58; 95% confidence interval (CI) 0.41 to 0.82). To evaluate the severity of Sore Throat on a visual analogue scale (VAS), 219 patients received topical or systemic lidocaine therapy and 152 patients were allocated to the control groups. The severity of Sore Throat was reduced (mean difference (MD) -11.9; 95% CI -16.44 to -7.32), an effect that neared statistical significance. The adverse effects of lidocaine were not reported in these studies. Our systematic review establishes the effectiveness of topical and systemic lidocaine for the prevention of postoperative Sore Throat resulting from intubation. The risk and severity of postoperative Sore Throat tended to be reduced. The effect size of lidocaine appeared to be affected by drug concentration and route of administration; management of cuff pressure during anaesthesia; the included population; and the type of outcome measured.
Chris Del Mar - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Antibiotics for preventing recurrent Sore Throat
The Cochrane database of systematic reviews, 2015Co-Authors: Stephanie Tan, Chris Del Mar, Mieke L Van DrielAbstract:Background: Antibiotics are sometimes used to prevent recurrent Sore Throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness. Objectives: To assess the effects of antibiotics in patients with recurrent Sore Throat. Search methods: The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015. Selection criteria: Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent Sore Throat, defined as three or more Sore Throats in a year, examining the incidence of Sore Throat recurrence, with follow-up of at least 12 months post-antibiotic therapy. Data collection and analysis: Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response. Main results: We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report. Authors' conclusions: There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent Sore Throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent Sore Throat on the following outcomes: incidence of Sore Throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
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corticosteroids as standalone or add on treatment for Sore Throat
Cochrane Database of Systematic Reviews, 2012Co-Authors: Gail Hayward, Chris Del Mar, Matthew Thompson, Rafael Perera, Paul Glasziou, Carl HeneghanAbstract:Sore Throat is a common condition associated with a high rate of antibiotic prescriptions, despite limited evidence for the effectiveness of antibiotics. Corticosteroids may improve symptoms of Sore Throat by reducing inflammation of the upper respiratory tract. To assess the clinical benefit and safety of corticosteroids for symptoms of Sore Throat in adults and children. We searched The Cochrane Library, the Cochrane Central Register of Controlled Trials (CENTRAL 2012, Issue 5) which includes the Acute Respiratory Infections (ARI) Group's Specialised Register, the Database of Reviews of Effects and the NHS Health Economics Database, MEDLINE (1966 to November Week 4, 2012) and EMBASE (1974 to June 2012). We included randomised controlled trials that compared steroids to either placebo or standard care in adults and children (older than three years of age) with Sore Throat. We excluded studies of hospitalised participants, those with infectious mononucleosis, Sore Throat following tonsillectomy or intubation, or peritonsillar abscess. Two review authors independently reviewed and selected trials from searches, assessed and rated study quality, and extracted relevant data. We included eight trials involving 743 participants (369 children and 374 adults). All trials gave antibiotics to both placebo and corticosteroid groups; no trials assessed corticosteroids as standalone treatment for Sore Throat. In addition to any effect of antibiotics and analgesia, corticosteroids increased the likelihood of complete resolution of pain at 24 hours by more than three times (risk ratio (RR) 3.2, 95% confidence interval (CI) 2.0 to 5.1, P < 0.001, I(2) statistic 44%) and at 48 hours by 1.7 times. Fewer than four people need to be treated to prevent one person continuing to experience pain at 24 hours. Corticosteroids also reduced the mean time to onset of pain relief and the mean time to complete resolution of pain by 6 and 14 hours, respectively, although significant heterogeneity was present. At 24 hours, pain (assessed by visual analogue scores) was reduced by an additional 14% by corticosteroids. No difference in rates of recurrence, relapse or adverse events were reported for participants taking corticosteroids compared to placebo, although reporting of adverse events was poor. Oral or intramuscular corticosteroids, in addition to antibiotics, increase the likelihood of both resolution and improvement of pain in participants with Sore Throat. Further trials assessing corticosteroids in the absence of antibiotics and in children are warranted.
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corticosteroids for pain relief in Sore Throat systematic review and meta analysis
BMJ, 2009Co-Authors: Gail Hayward, Chris Del Mar, Matthew Thompson, Rafael Perera, Carl Heneghan, Paul GlasziouAbstract:Objective To evaluate whether systemic corticosteroids improve symptoms of Sore Throat in adults and children. Design Systematic review and meta-analysis. Data sources Cochrane Central, Medline, Embase, Database of Reviews of Effectiveness (DARE), NHS Health Economics Database, and bibliographies. Outcome measures Percentage of patients with complete resolution at 24 and 48 hours, mean time to onset of pain relief, mean time to complete resolution of symptoms, days missed from work or school, recurrence, and adverse events. Results We included eight trials, consisting of 743 patients in total (369 children, 374 adults). 348 (47%) had exudative Sore Throat, and 330 (44%) were positive for group A β-haemolytic streptococcus. In addition to antibiotics and analgesia, corticosteroids significantly increased the likelihood of complete resolution of pain at 24 hours (four trials) by more than three times (relative risk 3.2, 95% confidence interval 2.0 to 5.1), and at 48 hours (three trials) to a lesser extent (1.7, 1.3 to 2.1). Corticosteroids (six trials) reduced mean time to onset of pain relief by more than 6 hours (95% confidence interval 3.4 to 9.3, P Conclusions Corticosteroids provide symptomatic relief of pain in Sore Throat, in addition to antibiotic therapy, mainly in participants with severe or exudative Sore Throat.
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Antibiotics for Sore Throat (Review)
Cochrane Database of Systematic Reviews, 2006Co-Authors: Chris Del Mar, Paul Glasziou, Annelise SpinksAbstract:1 Antibiotics for Sore Throat (Review) Copyright © 2007 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd Analysis by: age; blind versus unblinded; or use of antipyretics, found no significant differences. Analysis of results of Throat swabs showed that antibiotics were more effective against symptoms at day 3, RR 0.58 (95% CI 0.48 to 0.71) if the swabs were positive for Streptococcus, compared to RR 0.78 (95% CI 0.63 to 0.97) if negative. Similarly at week 1, RRs 0.29 (95% CI 0.12 to 0.70) for positive, and 0.73 (95% CI 0.50 to 1.07) for negative swabs. Authors’ conclusions Antibiotics confer relative benefits in the treatment of Sore Throat. However, the absolute benefits are modest. Protecting Sore Throat sufferers against suppurative and non-suppurative complications in modern Western society can only be achieved by treating many with antibiotics, most of whom will derive no benefit. In emerging economies (where rates of acute rheumatic fever are high, for example), the number needed to treat may be much lower for antibiotics to be considered effective. Antibiotics shorten the duration of symptoms by about sixteen hours overall. P L A I N L A N G U A G E S U M M A R Y Antibiotics are of limited use for most people with Sore Throats Sore Throats are infections caused by bacteria or viruses, affecting mostly children and young adults. People usually recover quickly (usually after three or four days), although some develop complications. A serious but rare one of these is rheumatic fever, which affects the heart and joints. Antibiotics reduce bacterial infections. But they can cause diarrhoea, rash and other adverse effects, and communities build resistance to them. This review of trials found that antibiotics shorten the illness by an average of about one day. They can reduce the chance of rheumatic fever in communities where this complication is common.
