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EBM THERAPY I
KELOMPOK A13
GENITOURINARY SYSTEM
2012
ABSTRACT
Background
The optimal duration of antibiotic therapy in older
patients with uncomplicated urinary tract infection (UTI)
is still a matter of debate. The aim of this randomized
controlled double-blind non-inferiority trial was to
compare that efficacy and safety of 3-day and 7-day
courses of oral ciprofloxacin for uncomplicated
symptomatic UTI in older women.
Methods
A total of 183 women at least 65 years old of age with
acute uncomplicated UTI were recruited from
ambulatory clinics and hospital acute care units. Patients
with pyelonephritis, contraindications to
fluoroquinolones, recent use of antibiotics, urinary tract
abnormalities, and diabetes mellitus were excluded.
Double-blind procedures were maintained throughout
ABSTRACT
Results
The proportion of patients with bacterial eradication
at 2 days after treatment was 98% in the 3-day
group and 93% in the 7-day group. The frequency
of adverse events, including drowsiness, headache,
nausea or vomiting, and loss of appetite, was
significantly lower in the 3-day group.
Interpretation
These results suggest that 3-day course of
antibiotic therapy is not inferior to a 7-day course
for treatment of uncomplicated symptomatic UTI in
older women, and that the shorter course is better
tolerated.
EBM THERAPY
WORKSHEET
Validity Importance Applicability
YES
NO
TOTAL
EXPERIMENTA
L
SUBJECTS
88
93
CONTROL
SUBJECTS
81
89
Calculations
Relative Risk Reduction (RRR)
Risk of the outcome in the treatment group / risk of
the outcome in the control group.
The RRR is the complement of the RR and is
probably the most commonly reported measure of
treatment effects. It tells us the reduction in the
rate of the outcome in the treatment group relative
to that in the control group.
Absolute Risk Reduction (ARR)
Risk of the outcome in the control group risk the
outcome in the treatment group. Also known as
Absolute Risk Differences. The ARR tells us the
absolute difference in the rates of events between
the two groups and gives an indication of the
baseline risk and treatment effects. An ARR of 0
means that there is no difference between the two
group thus, the treatment had no effect.
Calculations
Number Needed to Treat
Inverse of the ARR and is calculated as 1/ARR.
The NNT represents the number of patients we need
to treat with the experimental therapy in order to
prevent 1 bad outcome and incorporates the duration
of treatment.
CALCULATIONS
CER
EER
0,089 = 0,054 =
8,9%
5,4%
RRR
ARR
NNT
CER
EER
CER
CER EER
1/ARR
40%
0.036
28
95% CI
INTERPRETATION
RRR = 0.40 = 40%
The treatment reduced the risk of
death by 40% relative to that
occurring in the control group.
ARR = 0,036 = 3,6%
The absolute benefit of the
treatment is 3,6% reduction in the
death rate.
NNT = 28
We would need to treat 28 people
in order to prevent 1 death.
Yes.
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