Table 5

Summary of GRADE evidence profile of TMP-SMX vs clindamycin

Outcome/timeframeStudy results and measurementsAbsolute effect estimatesCertainty in effect estimates
(quality of evidence)
Plain text summary
ClindamycinTMP/SMX
Treatment failure/1 monthOR 1.08 (95% CI 0.69 to 1.75)
Based on data from 2673 patients in seven studies
Follow-up 7–30 days
109
per 1000
119
per 1000
High
Borderline imprecision*
There is no important difference in treatment failure.
Difference: 10 more per 1000
(95% CI 53 fewer—41 more)
Recurrence within/1 monthOR 2.14 (95% CI 1.11 to 4.12)
Based on data from 436 patients in one study
Follow-up 30 days
68
per 1000
135
per 1000
Low
Due to serious imprecision and serious inconsistency†
TMP/SMX probably results in higher risk of early abscess recurrence.
Difference: 67 more per 1000
(95% CI 7 more—163 more)
Diarrhoea/1 monthOR 0.29 (95% CI 0.16 to 0.55)
Based on data from 526 patients in one study
Follow-up 30 days
162
per 1000
53
per 1000
High‡TMP/SMX has a lower risk of diarrhoea.
Difference: 109 fewer per 1000
(95% CI 132 fewer—66 fewer)
Nausea/1 monthOR 1.9 (95% CI 0.69 to 5.21)
Based on data from 526 patients in one study
Follow-up 30 days
23
per 1000
43
per 1000
Moderate
Due to serious imprecision§
There is probably not an important difference in risk of nausea.
Difference: 20 more per 1000
(95% CI 7 fewer—86 more)
  • *Imprecision: no serious. Borderline wide CIs.

  • †Imprecision: serious. Data from one study only; CI approaches no difference; inconsistency: serious. The results are not consistent with the subgroup analysis, nor with the indirect evidence.

  • ‡Imprecision: no serious. Direct data from one study only. However, we did not rate down for imprecision because of high certainty indirect evidence from other conditions that clindamycin has a higher risk of diarrhoea than TMP/SMX.

  • §Imprecision: serious. Data from one study only; wide CIs.

  • GRADE, Grading of Recommendations Assessment, Development and Evaluation; TMP-SMX, trimethoprim and sulfamethoxazole.