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<meta name="citation_keywords" content="Antibiotic Prophylaxis">
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peritonitis" /></a></div><div class="bkr_bib"><h1 id="_NBK595736_"><span itemprop="name">Evidence review for the use of antibiotics to prevent spontaneous bacterial peritonitis</span></h1><div class="subtitle">Cirrhosis in over 16s: assessment and management (update)</div><p><b>Evidence review B</b></p><p><i>NICE Guideline, No. 50</i></p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2023 Sep</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-5351-6</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div></div><div class="bkr_clear"></div></div><div id="niceng50er2.s1"><h2 id="_niceng50er2_s1_">1. Primary prevention of spontaneous bacterial peritonitis</h2><div id="niceng50er2.s1.1"><h3>1.1. Review question</h3><p>What is the clinical and cost-effectiveness of antibiotics compared with placebo for the primary prevention of spontaneous bacterial peritonitis (SBP) in people with cirrhosis and ascites?</p><div id="niceng50er2.s1.1.1"><h4>1.1.1. Introduction</h4><p>NICE guideline <a href="https://www.nice.org.uk/guidance/ng50" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NG50</a> recommends prophylactic oral fluoroquinolones, specifically ciprofloxacin or norfloxacin, for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less, until the ascites has resolved, as primary prophylaxis for spontaneous bacterial peritonitis. NICE surveillance identified evidence that might impact this recommendation. Norfloxacin has been withdrawn in the UK and there is an <a href="https://www.gov.uk/drug-safety-update/fluoroquinolone-antibiotics-new-restrictions-and-precautions-for-use-due-to-very-rare-reports-of-disabling-and-potentially-long-lasting-or-irreversible-side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">MHRA Drug safety update on fluoroquinolones</a>. As a result, a new review of the evidence has been undertaken to allow a committee to consider any changes that may need to be made to the recommendation.</p></div><div id="niceng50er2.s1.1.2"><h4>1.1.2. Summary of the protocol</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab1"><a href="/books/NBK595736/table/niceng50er2.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab1" rid-ob="figobniceng50er2tab1"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab1/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab1/?report=previmg" alt="Table 1. PICOS inclusion criteria." /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab1"><a href="/books/NBK595736/table/niceng50er2.tab1/?report=objectonly" target="object" rid-ob="figobniceng50er2tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICOS inclusion criteria. </p></div></div></div><div id="niceng50er2.s1.1.3"><h4>1.1.3. Methods and process</h4><p>This evidence review was developed using the methods and process described in <a href="https://www.nice.org.uk/process/pmg20/chapter/introduction" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>. Methods specific to this review question are described in the review protocol in <a href="#niceng50er2.appa">appendix A</a> and the <a href="https://www.nice.org.uk/guidance/NG50/history" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">methods document</a>.</p><p>Declarations of interest were recorded according to <a href="https://www.nice.org.uk/about/who-we-are/policies-and-procedures" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NICE’s conflicts of interest policy</a>.</p><p>Scoping searches for this question identified a Cochrane network meta-analysis (NMA). The NMA is a near match for inclusion criteria for this review:
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<ul class="simple-list"><li class="half_rhythm"><div>Komolafe
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O, Roberts
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D, Freeman
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SC, Wilson
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P, Sutton
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AJ, Cooper
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NJ, Pavlov
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CS, Milne
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EJ, Hawkins
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N, Cowlin
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M, Thorburn
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D, Davidson
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BR, Tsochatzis
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E, Gurusamy
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KS. Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis: a network meta-analysis. Cochrane Database of Systematic Reviews
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2020, Issue 1. Art. No.: CD013125. 10.1002/14651858.CD013125.pub2. [<a href="/pmc/articles/PMC6984637/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6984637</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31978256" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31978256</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD013125.pub2" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></li></ul></p><p>The committee agreed that although the NMA covered people with and without ascites, and it also covered people who had previously had SBP, the NMA directly addresses the review question, was up to date and thorough, and that to repeat it would be a duplication of effort. They noted that the searches were run in November 2018, and that it was possible that newer studies that might be eligible for inclusion could have been published since that time. They asked NICE to update the searches to identify any potential new randomised controlled trials (RCTs) that would affect the <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al (2020)</a> NMA results.</p><p>The <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al (2020)</a> NMA included all the studies from the previous version of this review except for 1 study (Soriano G, Guarner C, Teixido M, Such J, Barrios J, Enriquez J et al. Selective intestinal decontamination prevents spontaneous bacterial peritonitis. Gastroenterology. 1991; 100(2):477–481. <a href="https://linkinghub.elsevier.com/retrieve/pii/0016508592915145" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://doi.org/10.1016/0016–5085(92)91514–5</a>). This study did not report data that could be fitted to the NMA and was therefore excluded (see <a href="#niceng50er2.appj">appendix J</a>).</p><div id="niceng50er2.s1.1.3.1"><h5>1.1.3.1. Search methods</h5><p>The searches for the clinical effectiveness evidence were run on 15th February 2023. The following databases were searched from November 2018 to February 2023: Central Register of Controlled Trials (Wiley), Cochrane Database of Systematic Reviews (Wiley), Embase (Ovid), Epistemonikos and MEDLINE (Ovid), MEDLINE-in-Process (Ovid), MEDLINE Epub Ahead-of-Print (Ovid). The searches were a rerun of the searches conducted for a previous <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013125.pub2/full" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cochrane Review</a>. The searches focused on antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with cirrhosis. Full search strategies for each database are provided in <a href="#niceng50er2.appb">appendix B</a>.</p><p>The searches for the cost effectiveness evidence were run on 15th February 2023. The economic search had no date limit as this type of evidence was not previously considered and the following databases were searched: EconLit (Ovid), Embase (Ovid), INAHTA and MEDLINE (Ovid), MEDLINE-in-Process (Ovid), MEDLINE Epub Ahead-of-Print (Ovid). A new search strategy based on the previous Cochrane Review search was used for the cost effectiveness searches. This expanded the Cochrane Review search to include additional terms around cirrhosis and antibiotics. Full search strategies for each database are provided in <a href="#niceng50er2.appb">appendix B</a>.</p><p>A NICE information specialist conducted the searches. The MEDLINE strategy was quality assured by a trained NICE information specialist and all translated search strategies were peer reviewed to ensure their accuracy. Both procedures were adapted from the <a href="https://www.sciencedirect.com/science/article/pii/S0895435616000585" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">2015 PRESS Guideline Statement</a>.</p></div></div><div id="niceng50er2.s1.1.4"><h4>1.1.4. Effectiveness evidence</h4><div id="niceng50er2.s1.1.4.1"><h5>1.1.4.1. Included studies</h5><p>The searches undertaken for the <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al (2020)</a> NMA in November 2018 were repeated to identify potentially relevant studies that had been published since the original search. This search found 263 references (see <a href="#niceng50er2.appb">appendix B</a> for the literature search strategy).</p><p>These 263 references were screened at title and abstract level against the review protocol, with 256 excluded at this level. 10% of references were screened separately by two reviewers with 100% agreement.</p><p>The full texts of 7 studies, 1 RCT and 6 SRs were ordered for closer inspection. The data from the RCT had already been included in the <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al 2020</a> NMA from a previous conference presentation so this study was excluded. The SRs were checked and no RCTs published since November 2018 had been missed.</p><p>The clinical evidence study selection is presented as a PRISMA diagram in <a href="#niceng50er2.appc">appendix C</a>.</p><p>See section <a href="#niceng50er2.s1.1.5">1.1.5 for a summary of studies included in the effectiveness evidence</a>, and section <a href="#niceng50er2.rl.r1">1.1.14 References - included studies</a> for the full reference of the included study.</p></div><div id="niceng50er2.s1.1.4.2"><h5>1.1.4.2. Excluded studies</h5><p>Details of studeis excluded at full text, along with reasons for exclusion are given in <a href="#niceng50er2.appj">appendix J</a>.</p></div></div><div id="niceng50er2.s1.1.5"><h4>1.1.5. Summary of studies included in the effectiveness evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab2"><a href="/books/NBK595736/table/niceng50er2.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab2" rid-ob="figobniceng50er2tab2"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab2/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab2/?report=previmg" alt="Table 2. Summary of studies included in the effectiveness evidence." /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab2"><a href="/books/NBK595736/table/niceng50er2.tab2/?report=objectonly" target="object" rid-ob="figobniceng50er2tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the effectiveness evidence. </p></div></div><p>See <a href="#niceng50er2.appd">appendix D</a> for full evidence tables.</p></div><div id="niceng50er2.s1.1.6"><h4>1.1.6. Summary of the effectiveness evidence</h4><p>These tables (<a class="figpopup" href="/books/NBK595736/table/niceng50er2.tab3/?report=objectonly" target="object" rid-figpopup="figniceng50er2tab3" rid-ob="figobniceng50er2tab3">Table 3</a> and <a class="figpopup" href="/books/NBK595736/table/niceng50er2.tab4/?report=objectonly" target="object" rid-figpopup="figniceng50er2tab4" rid-ob="figobniceng50er2tab4">Table 4</a>) are the GRADE summary of findings tables from <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al (2020)</a> and present a summary of the effectiveness estimates from the NMA. See <a href="#niceng50er2.s1.1.11">section 1.1.11</a> of this document for brief narrative summaries of the evidence (evidence statements).</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab3"><a href="/books/NBK595736/table/niceng50er2.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab3" rid-ob="figobniceng50er2tab3"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab3/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab3/?report=previmg" alt="Table 3. Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis." /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab3"><a href="/books/NBK595736/table/niceng50er2.tab3/?report=objectonly" target="object" rid-ob="figobniceng50er2tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab4"><a href="/books/NBK595736/table/niceng50er2.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab4" rid-ob="figobniceng50er2tab4"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab4/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab4/?report=previmg" alt="Table 4. Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis – comparison by antibiotic." /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab4"><a href="/books/NBK595736/table/niceng50er2.tab4/?report=objectonly" target="object" rid-ob="figobniceng50er2tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis – comparison by antibiotic. </p></div></div></div><div id="niceng50er2.s1.1.7"><h4>1.1.7. Economic evidence</h4><div id="niceng50er2.s1.1.7.1"><h5>1.1.7.1. Included economic studies</h5><p>A search was performed to identify published economic evaluations of relevance to this guideline update. This search retrieved 500 studies. Based on title and abstract screening, all the studies were excluded for this question.</p></div><div id="niceng50er2.s1.1.7.2"><h5>1.1.7.2. Excluded economic studies</h5><p>No studies were examined at full text.</p></div></div><div id="niceng50er2.s1.1.8"><h4>1.1.8. Summary of included economic evidence</h4><p>No economic studies were included in this review.</p></div><div id="niceng50er2.s1.1.9"><h4>1.1.9. Economic model</h4><p>We conducted an analysis to evaluate the cost savings that could be generated by giving antibiotics to people with ascites by preventing SBP. To be cost saving, ciprofloxacin has to prevent at least one episode of SBP per 43.32 person years. The clinical evidence shows that prophylactic treatment with ciprofloxacin could reduce incidence of SBP by an average of 62 cases per 1000 (i.e.1 SBP episode in every 16 people), which is within the threshold. We are not able to quantify cost savings for rifaximin and co-trimoxazole due to the lack of robust clinical evidence. The full write up of the methods and results is in <a href="#niceng50er2.appi">Appendix I</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab5"><a href="/books/NBK595736/table/niceng50er2.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab5" rid-ob="figobniceng50er2tab5"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab5/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab5/?report=previmg" alt="Table 5. Health economic evidence profile: antibiotics vs placebo for preventing spontaneous bacterial peritonitis." /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab5"><a href="/books/NBK595736/table/niceng50er2.tab5/?report=objectonly" target="object" rid-ob="figobniceng50er2tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Health economic evidence profile: antibiotics vs placebo for preventing spontaneous bacterial peritonitis. </p></div></div></div><div id="niceng50er2.s1.1.10"><h4>1.1.10. Unit costs</h4><p>The costs of the drugs and the management costs of SBP included in recommendations for this review question are given below, respectively. For further details about how the management costs of SBP were calculated, see <a href="#niceng50er2.appi">Appendix I</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab6"><a href="/books/NBK595736/table/niceng50er2.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab6" rid-ob="figobniceng50er2tab6"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab6/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab6/?report=previmg" alt="Table 6. Unit costs of antibiotics." /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab6"><a href="/books/NBK595736/table/niceng50er2.tab6/?report=objectonly" target="object" rid-ob="figobniceng50er2tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Unit costs of antibiotics. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab7"><a href="/books/NBK595736/table/niceng50er2.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab7" rid-ob="figobniceng50er2tab7"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab7/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab7/?report=previmg" alt="Table 7. Management costs of SBP." /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab7"><a href="/books/NBK595736/table/niceng50er2.tab7/?report=objectonly" target="object" rid-ob="figobniceng50er2tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Management costs of SBP. </p></div></div></div><div id="niceng50er2.s1.1.11"><h4>1.1.11. Evidence statements</h4><div id="niceng50er2.s1.1.11.1"><h5>Effectiveness evidence: primary outcomes</h5><p>The outcomes of the NMA were presented as hazard ratio (HR) or odds ratios (OR), and credible intervals (Crl) (Crl are essentially similar to a 95% confidence interval but incorporates problem-specific contextual information from prior distributions as well as the present study data - Yang et al 2022). A HR or OR<1 favours treatment over control, a HR or OR>1 favours control over treatment and a HR or OR=1 demonstrates treatment equivalence. To demonstrate a significant effect the Crl surrounding the HR or OR will not go through the line of effect (HR or OR=1).</p></div><div id="niceng50er2.s1.1.11.2"><h5>All-cause mortality</h5><p>Based on network estimates with very low certainty of evidence, 17 studies containing 2,169 participants were unable to demonstrate a difference between no intervention/placebo and</p><ul><li class="half_rhythm"><div>rifaximin (HR 0.57; 95% CrI 0.33 to 1.00)</div></li><li class="half_rhythm"><div>norfloxacin (HR 0.74; 95% CrI 0.49 to 1.09)</div></li><li class="half_rhythm"><div>ciprofloxacin (HR 0.61; 95% CrI 0.31 to 1.16)</div></li><li class="half_rhythm"><div>sulfamethoxazole + trimethoprim (HR 0.47; 95% CrI 0.20 to 1.00)</div></li><li class="half_rhythm"><div>norfloxacin + rifaximin (HR 0.40; 95% CrI 0.12 to 1.17) or</div></li><li class="half_rhythm"><div>rufloxacin (HR 1.45; 95% CrI 0.27 to 8.21)</div></li></ul><p>on all-cause mortality.</p></div><div id="niceng50er2.s1.1.11.3"><h5>Health-related quality of life</h5><p>None of the trials included in the NMA reported this outcome.</p></div><div id="niceng50er2.s1.1.11.4"><h5>Proportion of participants with one or more serious adverse event</h5><p>None of the trials included in the NMA reported this outcome.</p></div><div id="niceng50er2.s1.1.11.5"><h5>Number of serious adverse events per participant</h5><p>Based on a direct estimate with very low certainty of evidence, 2 studies containing 353 participants were unable to demonstrate a difference between no intervention/placebo and rifaximin (Rate ratio 1.66; 95% CI 0.98 to 2.90) for the number of serious adverse events per participant.</p></div><div id="niceng50er2.s1.1.11.6"><h5>Effectiveness evidence: secondary outcomes</h5></div><div id="niceng50er2.s1.1.11.7"><h5>Proportion of participants with one or more adverse event</h5><p>Based on network estimates with very low certainty of evidence, 3 studies containing 631 participants were unable to demonstrate a difference between no intervention/placebo and
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<ul><li class="half_rhythm"><div>rifaximin (OR 1.01; 95% CrI 0.00 to 853.21)</div></li><li class="half_rhythm"><div>norfloxacin (OR 11.85; 95% CrI 0.01 to 263,023.85)</div></li></ul></p><p>for the proportion of participants with one or more adverse event.</p></div><div id="niceng50er2.s1.1.11.8"><h5>Number of adverse events per participant</h5><p>Based on direct estimates, the number of 'any' adverse events per participant was fewer with
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<ul><li class="half_rhythm"><div>norfloxacin (rate ratio 0.74; 95% CrI 0.59 to 0.94; 4 trials, 546 participants; low certainty)</div></li><li class="half_rhythm"><div>sulfamethoxazole plus trimethoprim (rate ratio 0.19; 95% CrI 0.02 to 0.81; 1 trial, 60 participants; low certainty)</div></li></ul></p><p>versus no active intervention.</p><p>Based on direct estimates, the review was unable to demonstrate a difference between
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<ul><li class="half_rhythm"><div>rifaximin (rate ratio 1.15; 95% CrI 0.98 to 1.34; 3 trials, 418 participants; very low certainty)</div></li><li class="half_rhythm"><div>ciprofloxacin (rate ratio 0.72; 95% CrI 0.49 to 1.05; 3 trials, 255 participants; very low certainty)</div></li></ul></p><p>versus no active intervention.</p></div><div id="niceng50er2.s1.1.11.9"><h5>Liver transplantation</h5><p>Based on network estimates with very low certainty of evidence, 3 studies containing 260 participants were unable to demonstrate a difference between no intervention/placebo and
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<ul><li class="half_rhythm"><div>norfloxacin (HR 0.93; 95% CrI 0.31 to 3.44)</div></li><li class="half_rhythm"><div>ciprofloxacin (HR 0.62; 95% CrI 0.12 to 3.31)</div></li><li class="half_rhythm"><div>sulfamethoxazole + trimethoprim (HR 2.62; 95% CrI 0.62 to 11.91)</div></li></ul></p><p>for liver transplantation</p></div><div id="niceng50er2.s1.1.11.10"><h5>Spontaneous bacterial peritonitis</h5><p>Based on direct estimates with very low certainty evidence, the NMA was unable to demonstrate a difference between no intervention/placebo and
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<ul><li class="half_rhythm"><div>rifaximin (HR 7.80; 95% CrI 0.13 to 4,647.11; 2 trials, 106 participants)</div></li><li class="half_rhythm"><div>norfloxacin (HR 0.16; 95% CrI 0.00 to 1.56; 3 trials, 255 participants)</div></li><li class="half_rhythm"><div>ciprofloxacin (HR 0.56; 95% CrI 0.02 to 60.64; 3 trials, 255 participants)</div></li><li class="half_rhythm"><div>sulfamethoxazole + trimethoprim (HR not estimable based on 1 trial of 60 participants)</div></li></ul></p><p>for spontaneous bacterial peritonitis.</p></div><div id="niceng50er2.s1.1.11.11"><h5>Number of decompensation episodes per participant</h5><p>Based on 8 studies with 1,275 participants there were fewer decompensation events with</p><ul><li class="half_rhythm"><div>rifaximin (rate ratio 0.61, 65% CrI 0.46 to 0.80; low certainty)</div></li><li class="half_rhythm"><div>norfloxacin plus neomycin (rate ratio 0.06, 95% CrI 0.00 to 0.33; low certainty)</div></li></ul><p>versus no active intervention.</p><p>Based on direct estimates, the NMA was unable to demonstrate a difference between
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<ul><li class="half_rhythm"><div>norfloxacin plus rifaximin (rate ratio 0.33; 95% CrI 0.04 to 1.40; no direct RCT; very low certainty)</div></li></ul></p><p>versus no active intervention</p></div><div id="niceng50er2.s1.1.11.12"><h5>Economic evidence</h5><ul><li class="half_rhythm"><div>Based on the estimates of effect from the effectiveness review, an economic analysis demonstrated that ciprofloxacin may provide cost savings by preventing episodes of SBP. It was not possible to estimate cost savings for co-trimoxazole due to a lack of evidence for this outcome, and very low certainty evidence for rifaximin indicated that it was not more effective than placebo for preventing SBP and therefore would not be associated with cost savings.</div></li></ul></div></div><div id="niceng50er2.s1.1.12"><h4>1.1.12. The committee's discussion and interpretation of the evidence</h4><div id="niceng50er2.s1.1.12.1"><h5>1.1.12.1. The outcomes that matter most</h5><p>The committee agreed that the most important outcomes for this question were mortality, quality of life and adverse events, since these were the key outcomes for people living with cirrhosis and ascites. They also noted that it was important to look at the time to development of spontaneous bacterial peritonitis (SBP), and proxy measures like liver transplantation and other kinds of decompensation. The committee also agreed that it was very important to look at the evidence from a perspective of good antimicrobial stewardship. They commented that they were aware that antimicrobial resistance may be higher among people with cirrhosis and ascites who have had frequent antimicrobial treatment, although that evidence was not formally part of this review.</p></div><div id="niceng50er2.s1.1.12.2"><h5>1.1.12.2. The quality of the evidence</h5><p>The committee considered the evidence from a Cochrane network meta-analysis (<a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al, 2020</a>). The network meta-analysis (NMA) looked for evidence for all-cause mortality, health-related quality of life, proportion of participants with one or more serious adverse events, number of serious adverse events per participants, proportion of participants with one or more adverse events, number of adverse events per participant, liver transplantation, spontaneous bacterial peritonitis and number of decompensation episodes per participant, There was no evidence for health-related quality of life and proportion of participants with one or more serious adverse event. All of the evidence in this NMA was of low or very low quality. This is because, in spite of including 23 studies, most of the studies were small and poorly reported. This meant that most of the evidence was downgraded for risk of methodological bias (mostly for selective reporting and for lack of blinding) and for imprecision, because the size of the studies made the 95% credible intervals very wide.</p><p>The committee also considered the recommendation from the previous guideline which recommended ciprofloxacin or norfloxacin for preventing SBP.</p></div><div id="niceng50er2.s1.1.12.3"><h5>1.1.12.3. Benefits and harms</h5><p>The committee discussed the UK context for this question, and agreed that in spite of the NICE guidance, practice in relation to preventing SBP in people with cirrhosis and ascites was very variable, and that it was mostly dependent on individual clinicians whether they prescribed prophylactic antibiotics for people with ascites and a low ascitic protein.</p><p>The committee noted that previously, ciprofloxacin or norfloxacin were routinely used for preventing SBP in people at high risk, but norfloxacin has been withdrawn in the UK and ciprofloxacin is subject to an MHRA drug safety update on the fluoroquinolone class of antibiotics. (<a href="https://www.gov.uk/drug-safety-update/fluoroquinolone-antibiotics-new-restrictions-and-precautions-for-use-due-to-very-rare-reports-of-disabling-and-potentially-long-lasting-or-irreversible-side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">MHRA drug safety update</a>) because of potentially irreversible adverse reactions meant that they were no longer the drug of choice in this indication.</p><p>The evidence from the NMA could not demonstrate a difference between any of the antibiotics and no intervention in terms of mortality (very low certainty) or number of serious adverse events (very low certainty). None of the studies reported health related quality of life. The committee noted that the central effect estimates for many of the antibiotics showed quite substantial effects, and were they correct they would be clinically important, however there was a great deal of uncertainty associated with the effect estimates which is likely to be due to the small study sizes.</p><p>The committee discussed this and noted that because the credible intervals were so wide, it was difficult to assess whether there were clinically important effects, and that important differences cannot be ruled out. This lack of certainty meant that they made a weaker recommendation and added a research recommendation (<a href="#niceng50er2.appk">appendix K</a>) to encourage further, better quality studies in this area to allow a more definitive recommendation when it is next updated by NICE.</p><p>The committee noted that for some of the secondary outcomes there were statistically significant effects for norfloxacin and sulfamethoxazole plus trimethoprim versus no active intervention for the number of any adverse events per participants; and rifaximin and norfloxacin plus neomycin versus no active intervention for the number of decompensation episodes per participant. As these findings were of low certainty and focused on secondary outcomes the committee did not make any recommendations in these areas.</p><p>Based on the committees’ expertise and experience in practice, the low-quality evidence and the cautions around the use of fluoroquinolones, the committee agreed that antibiotics might have a role in preventing SBP in some people who were considered to be at particularly high risk of SBP (for example people with a low ascitic protein (<15g/dl) or severe liver disease (Child-Pugh ≥9 or MELD ≥16 with recurrent ascites), or in whom the consequences were likely to be severe, but that good antimicrobial stewardship was also important. They noted that people with cirrhosis and ascites who frequently had prophylactic antibiotics had higher rates of antibiotic resistant infection than the general population. In light of these discussions the committee agreed to withdraw the previous recommendation to offer prophylactic oral ciprofloxacin or norfloxacin to people at high risk of developing SBP and updated the recommendation to specify that antibiotics should be prescribed to people at high risk according to local microbiological data and funding agreement. On the basis of the discussion above, they broadened the definition of high risk and gave examples of what could be considered high risk. They added a further group to the recommendation because they agreed that prophylactic antibiotics could be justified for people where their care would be severely impacted by an episode of SBP, for example if they were waiting for a transplant or a TIPS procedure.</p><p>Overall, the committee agreed that the recommendation made a good balance between antimicrobial stewardship and good patient care by recommending the use of prophylactic antibiotics in people at high risk. They agreed that local infection patterns and microbiological advice were probably the most useful determinants of which antibiotic to prescribe.</p></div><div id="niceng50er2.s1.1.12.4"><h5>1.1.12.4. Cost effectiveness and resource use</h5><p>No recent and relevant published economic studies were identified.</p><p>We conducted an analysis to evaluate any potential cost savings that could be generated by giving antibiotics to people with ascites at high risk of developing SBP. This analysis considers the costs of antibiotics and the management cost of SBP. The annual costs of each antibiotic for preventing SBP are estimated to be £46.72 for ciprofloxacin, £3,379.25 for rifaximin and £88.77 for co-trimoxazole. The committee noted that rifaximin was much more expensive than the rest of antibiotics, and that it is not typically on local prescribing protocols for this indication. The cost of managing SBP-related complications was estimated to be approximately £2,000, taking into account typical resources for managing SBP such as paracentesis, ultrasound, 7-day hospital stay and 5-day course of tazoxin. The committee described how the management of SBP was complicated and varied greatly by patient, and the costs depended upon the further development of their condition.</p><p>To be cost saving, prophylactic treatment needs to prevent at least one episode of SBP per 43.32 person years for ciprofloxacin and one episode per 22.80 person years for co-trimoxazole. The clinical evidence from the Cochrane review for people with ascites at high risk of developing SBP shows that ciprofloxacin can reduce incidence of SBP by 62 cases per 1000 people (1 SBP episode in every 16 people). Hence, using ciprofloxacin may be cost saving compared with no active intervention. However, there is a lack of clinical data to quantify the cost savings for cotrimoxazole. Prophylactic treatment with rifaximin is more costly than treating an episode of SBP each year (£3,379 vs £2,024). The poor-quality clinical evidence where the risk difference with rifaximin is 860 more per 1,000 also suggests that people with rifaximin are more likely to develop SBP than no active intervention, and so we are not able to quantify the cost savings for rifaximin.</p><p>Ciprofloxacin belongs to the fluroquinolone class, which are no longer considered as the first choice of antibiotics for prophylaxis due to their associated risks to patients.</p><p>As a result of very low certainty evidence on adverse effects of fluoroquinolones, it is difficult to weigh up their impact and the risk of developing SBP, and to quantify the economic impact of managing these adverse effects. The committee argued that not everyone will experience side effects of fluoroquinolones and that it is possible to identify those at high risk of SBP and that these people might benefit from antibiotic prophylaxis. The committee lacks strong evidence to recommend the best option for the primary prevention of SBP, and so felt that it was more appropriate to advise centres to refer to local prescribing protocols for these patients.</p><p>The committee advised that people with the G6PD deficiency, an inherited condition which results in an inadequate number of enzymes for healthy, functioning red blood cells, are advised to avoid using fluoroquinolones and co-trimoxazole. It is more common in men than women and in people with Asian, African or Mediterranean heritage. Testing for this condition is not part of routine practice and only done if there is a clinical suspicion, such as suspected haemolytic anaemia or a family history of the condition. If a person who has G6PD deficiency is prescribed certain drugs, they may be at a higher risk of developing adverse events such as haemolytic anaemia, jaundice, dizziness, headache. Treating people with G6PD deficiency with inappropriate antibiotics may have resource implications because of the treatment of adverse events. However, the cost of a test for G6PD is minimal compared to the cost of managing SBP and the associated adverse effects of giving fluoroquinolones to those with G6PD deficiency. Overall, this is unlikely to impact upon the cost effectiveness results since this will likely affect only a very small number of people within the cirrhotic population.</p></div><div id="niceng50er2.s1.1.12.5"><h5>1.1.12.5. Other factors the committee took into account</h5><p>The committee discussed the potential equalities issues relating to medicines compliance and support, antibiotic contraindication and fluoroquinolone use. The committee agreed that the new recommendation was unlikely to increase inequalities in any particular group of people, and that the new recommendation would remove the risk of the potentially negative impact of prescribing fluoroquinolones for this indication.</p></div></div><div id="niceng50er2.s1.1.13"><h4>1.1.13. Recommendations supported by this evidence review</h4><p>This evidence review supports recommendation 1.3.6 to 1.3.8 and the research recommendation on antibiotic prophylaxis to prevent spontaneous bacterial peritonitis.</p></div><div id="niceng50er2.rl.r1"><h4>1.1.14. References – included studies</h4><ul class="simple-list"><div id="niceng50er2.rl.r1.1"><h5>1.1.14.1. Effectiveness</h5><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng50er2.ref1">Komolafe
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O, Roberts
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D, Freeman
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SC, Wilson
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P, Sutton
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AJ, Cooper
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NJ, Pavlov
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CS, Milne
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EJ, Hawkins
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N, Cowlin
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M, Thorburn
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D, Davidson
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BR, Tsochatzis
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E, Gurusamy
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KS. Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis: a network meta-analysis. Cochrane Database of Systematic Reviews
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2020, Issue 1. Art. No.: CD013125.10.1002/14651858.CD013125.pub2. [<a href="/pmc/articles/PMC6984637/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6984637</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31978256" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31978256</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD013125.pub2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></p></li></ul></div><div id="niceng50er2.rl.r1.2"><h5>1.1.14.2. Economic</h5><ul class="simple-list"><p>None</p></ul></div><div id="niceng50er2.rl.r1.3"><h5>1.1.14.3. Other references</h5><ul class="simple-list"><li class="half_rhythm"><p><div class="bk_ref" id="niceng50er2.ref3">Aithal
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G. P., Palaniyappan
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N., China
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L., Härmälä
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S., Macken
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L., Ryan
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J. M., Wilkes
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E. A., Moore
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K., Leithead
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J. A., Hayes
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P. C., O'Brien
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A. J., & Verma
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S. (2021). Guidelines on the management of ascites in cirrhosis. Gut, 70(1), 9–29. 10.1136/gutjnl-2020-321790 [<a href="/pmc/articles/PMC7788190/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7788190</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33067334" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33067334</span></a>] [<a href="http://dx.crossref.org/10.1136/gutjnl-2020-321790" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng50er2.ref4">British National Formulary (2023). Accessed at: <a href="https://www.nice.org.uk/bnf-uk-only" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://bnf<wbr style="display:inline-block"></wbr>​.nice.org.uk/</a></div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng50er2.ref5">National Schedule of NHS Costs 2019/20. Accessed at: <a href="https://www.england.nhs.uk/publication/2019-20-national-cost-collection-data-publication/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.england.nhs<wbr style="display:inline-block"></wbr>​.uk/publication/2019-20-national-cost-collection-data-publication/</a></div></p></li><li class="half_rhythm"><p><div class="bk_ref" id="niceng50er2.ref6">Unit Costs of Health and Social Care (PSSRU) 2020. Accessed at: <a href="https://www.pssru.ac.uk/project-pages/unit-costs/unit-costs-2020/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.pssru.ac<wbr style="display:inline-block"></wbr>​.uk/project-pages/unit-costs<wbr style="display:inline-block"></wbr>​/unit-costs-2020/</a></div></p></li></ul></div></ul></div></div></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">Appendices</h2><div id="niceng50er2.appa"><h3>Appendix A. Review protocols</h3><p>This review reports a network meta-analysis undertaken by <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al (2020)</a> for Cochrane. Please see that paper for details of the protocol.</p></div><div id="niceng50er2.appb"><h3>Appendix B. Literature search strategies</h3><div id="niceng50er2.appb.s1"><h4>Background and development</h4><div id="niceng50er2.appb.s1.1"><h5>Search design and peer review</h5><p>A NICE information specialist conducted the literature searches for the evidence review. The searches were run on 15<sup>th</sup> February 2023. This search report is compliant with the requirements of the PRISMA Statement for Reporting Literature Searches in Systematic Reviews (for further details see: Rethlefsen M et al. <a href="https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-020-01542-z" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRISMA-S</a>. <i>Systematic Reviews</i>, 10(1), 39).</p><p>The MEDLINE strategies below were quality assured (QA) by a trained NICE information specialist. All translated search strategies were peer reviewed to ensure their accuracy. Both procedures were adapted from the Peer Review of Electronic Search Strategies Guideline Statement (for further details see: McGowan J et al. <a href="https://www.sciencedirect.com/science/article/pii/S0895435616000585" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PRESS 2015 Guideline Statement</a>. <i>Journal of Clinical Epidemiology</i>, 75, 40–46).</p><p>The principal search strategies were developed in MEDLINE (Ovid interface) and adapted, as appropriate, for use in the other sources listed in the protocol, taking into account their size, search functionality and subject coverage.</p></div><div id="niceng50er2.appb.s1.2"><h5>Review management</h5><p>The search results were managed in EPPI-Reviewer v5. Duplicates were removed in EPPI-R5 using a two-step process. First, automated deduplication is performed using a high-value algorithm. Second, manual deduplication is used to assess ‘low-probability’ matches. All decisions made for the review can be accessed via the deduplication history.</p></div><div id="niceng50er2.appb.s1.3"><h5>Prior work</h5><p>The clinical search is a direct rerun of the search conducted for the following Cochrane review; the search strategy matches the search strategy used in this review:</p><p>
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Komolafe
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O, Roberts
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D, Freeman
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SC
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et al (2020) Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis: a network meta-analysis. Cochrane Database of Systematic Reviews
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issue 1: CD013125 [<a href="/pmc/articles/PMC6984637/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6984637</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31978256" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31978256</span></a>]
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</p><p>The economic search expanded the search strategy originally used in the Cochrane review to include additional search terms around cirrhosis, antibiotic prophylaxis, and specific antibiotics. This is because economic evidence was not considered as part of the original Cochrane review and with the potentially smaller evidence base additional search terms were considered useful in identify relevant evidence.</p></div><div id="niceng50er2.appb.s1.4"><h5>Limits and restrictions</h5><p>English language limits were applied in adherence to standard NICE practice.</p><p>The clinical search was limited from November 2018 to February 2023. The economic search had no date limit as this type of evidence was not previously considered as part of the Cochrane review.</p><p>The limit to remove animal studies in the searches was the standard NICE practice, which has been adapted from: Dickersin K, Scherer R & Lefebvre C. (1994) <a href="https://www.bmj.com/content/309/6964/1286" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Systematic Reviews: Identifying relevant studies for systematic reviews</a>. <i>BMJ</i>, 309(6964), 1286.</p></div><div id="niceng50er2.appb.s1.5"><h5>Search filters and classifiers</h5><div id="niceng50er2.appb.s1.5.1"><h5>Clinical searches</h5><ul><li class="half_rhythm"><div>RCT filters:
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<ul class="circle"><li class="half_rhythm"><div class="half_rhythm"><a href="https://hiruweb.mcmaster.ca/hkr/hedges/medline/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">McMaster Therapy – Medline - “best balance of sensitivity and specificity” version</a>.</div><div class="half_rhythm">Haynes
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RB
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et al (2005) Optimal search strategies for retrieving scientifically strong studies of treatment from Medline: analytical survey. <em>BMJ</em>, 330, 1179–1183. [<a href="/pmc/articles/PMC558012/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC558012</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15894554" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15894554</span></a>]</div></li><li class="half_rhythm"><div class="half_rhythm"><a href="https://hiruweb.mcmaster.ca/hkr/hedges/embase/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">McMaster Therapy – Embase</a> “best balance of sensitivity and specificity” version.</div><div class="half_rhythm">Wong
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SSL
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et al (2006) Developing optimal search strategies for detecting clinically sound treatment studies in EMBASE. Journal of the Medical Library Association, 94(1), 41–47. [<a href="/pmc/articles/PMC1324770/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1324770</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/16404468" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16404468</span></a>]</div></li></ul></div></li><li class="half_rhythm"><div>• Systematic reviews filters:
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<ul class="simple-list"><li class="half_rhythm"><div>Lee, E.
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et al (2012) An optimal search filter for retrieving systematic reviews and meta-analyses. <em>BMC Medical Research Methodology,</em>
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12(1), 51. [<a href="/pmc/articles/PMC3515398/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3515398</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22512835" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22512835</span></a>]</div></li></ul></div></li></ul><p>In MEDLINE, the standard NICE modifications were used: pubmed.tw added; systematic review.pt added from MeSH update 2019.</p><p>In Embase, the standard NICE modifications were used: pubmed.tw added to line medline.tw.</p></div><div id="niceng50er2.appb.s1.5.2"><h5>Cost effectiveness searches</h5><p>The following search filters were applied to the search strategies in MEDLINE and Embase to identify cost-effectiveness studies:
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<ul><li class="half_rhythm"><div>Glanville
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J
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et al (2009) Development and Testing of Search Filters to Identify Economic Evaluations in MEDLINE and EMBASE. Alberta: Canadian Agency for Drugs and Technologies in Health (CADTH)</div></li><li class="half_rhythm"><div>Hubbard
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W, Walsh
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N, Hudson
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T
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et al (2022) Development and validation of paired MEDLINE and Embase search filters for cost-utility studies. BMC Medical Research Methodology
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22(1), 310 [<a href="/pmc/articles/PMC9719242/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9719242</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36463100" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36463100</span></a>]</div></li></ul></p></div><div id="niceng50er2.appb.s1.5.3"><h5>Key decisions</h5><p>The clinical search strategy was a direct copy of that run in the original Cochrane review, this was following the decision to use this review as the basis for any recommendations made within the guideline. The search was rerun to identify any relevant evidence published since November 2018 when the Cochrane review search was last run.</p><p>The economic search expanded the search strategy originally used in the Cochrane review to include additional search terms around cirrhosis, antibiotic prophylaxis, and specific antibiotics that were identified in the published Cochrane review. The economic search was not a rerun of the Cochrane review as this evidence was not considered as part of that review but a new search as part of this guideline. Given the potentially smaller evidence base additional search terms were considered useful in identify any relevant evidence.</p><p>In January 2023 there was a data processing error in Ovid Embase. This error was fixed on 22<sup>nd</sup> February 2023. Additional results missed during the data processing error in Embase were added to the total search results on 22<sup>nd</sup> February 2023.</p></div></div></div><div id="niceng50er2.appb.s1.6"><h4>Clinical searches</h4><div id="niceng50er2.appb.s1.6.1"><h5>Main search – Databases</h5><p id="niceng50er2.appb.et1"><a href="/books/NBK595736/bin/niceng50er2-appb-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (194K)</span></p></div></div><div id="niceng50er2.appb.s1.7"><h4>Cost-effectiveness searches</h4><div id="niceng50er2.appb.s1.7.1"><h5>Main search – Databases</h5><p id="niceng50er2.appb.et2"><a href="/books/NBK595736/bin/niceng50er2-appb-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (288K)</span></p></div></div></div><div id="niceng50er2.appc"><h3>Appendix C. Effectiveness evidence study selection</h3><p id="niceng50er2.appc.et1"><a href="/books/NBK595736/bin/niceng50er2-appc-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (127K)</span></p></div><div id="niceng50er2.appd"><h3>Appendix D. Effectiveness evidence</h3><p id="niceng50er2.appd.et1"><a href="/books/NBK595736/bin/niceng50er2-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (202K)</span></p></div><div id="niceng50er2.appe"><h3>Appendix E. Forest plots</h3><p>No forest plots were produced for this review because no meta-analysis was undertaken.</p><p>The included NMA presents network diagrams for the comparators it includes – see figure 1 in <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al (2020)</a>.</p><p>Some additional plots were not included in the NMA due to concerns about consistency in the network. They can be accessed via <a href="https://zenodo.org/record/3457887#.ZBmGPXbP2Um" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://zenodo.org/record/3457887#.ZBmGPXbP2Um</a>.</p></div><div id="niceng50er2.appf"><h3>Appendix F. GRADE tables</h3><p>No GRADE tables were produced for this review. The outcomes reported in <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al (2020)</a> and reproduced in <a class="figpopup" href="/books/NBK595736/table/niceng50er2.tab3/?report=objectonly" target="object" rid-figpopup="figniceng50er2tab3" rid-ob="figobniceng50er2tab3">tables 3</a> and <a class="figpopup" href="/books/NBK595736/table/niceng50er2.tab4/?report=objectonly" target="object" rid-figpopup="figniceng50er2tab4" rid-ob="figobniceng50er2tab4">4</a> in this review give the summary GRADE assessment made by <a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al 2020</a>.</p></div><div id="niceng50er2.appg"><h3>Appendix G. Economic evidence study selection</h3><p id="niceng50er2.appg.et1"><a href="/books/NBK595736/bin/niceng50er2-appg-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (90K)</span></p></div><div id="niceng50er2.apph"><h3>Appendix H. Economic evidence tables</h3><p>No economic studies were included in this review.</p></div><div id="niceng50er2.appi"><h3>Appendix I. Health economic model</h3><p id="niceng50er2.appi.et1"><a href="/books/NBK595736/bin/niceng50er2-appi-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (227K)</span></p></div><div id="niceng50er2.appj"><h3>Appendix J. Excluded studies</h3><div id="niceng50er2.appj.s1.1"><h4>Effectiveness evidence</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng50er2tab8"><a href="/books/NBK595736/table/niceng50er2.tab8/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figniceng50er2tab8" rid-ob="figobniceng50er2tab8"><img class="small-thumb" src="/books/NBK595736/table/niceng50er2.tab8/?report=thumb" src-large="/books/NBK595736/table/niceng50er2.tab8/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="niceng50er2.tab8"><a href="/books/NBK595736/table/niceng50er2.tab8/?report=objectonly" target="object" rid-ob="figobniceng50er2tab8">Table</a></h4><p class="float-caption no_bottom_margin">- Duplicate reference
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<i>This is the final publication of data that was already included in the Komolafe NMA from a conference abstract (Praharaj 2017 in the Komolafe NMA).</i>
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</p></div></div></div><div id="niceng50er2.appj.s1.2"><h4>Economic evidence</h4><p>None screened at full text</p></div></div><div id="niceng50er2.appk"><h3>Appendix K. Research recommendations – full details</h3><div id="niceng50er2.appk.s1"><h4>K1.1. Research recommendation</h4><p>What is the clinical and cost-effectiveness of antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with cirrhosis and ascites?</p><div id="niceng50er2.appk.s1.1"><h5>K1.1.1. Why this is important</h5><p>Current evidence is based on methodologically poor studies with small sample sizes and this means that the committee did not find the evidence useful for decision making. Better quality evidence from larger trials will enable a future committee to make a stronger recommendation about the potential use of antibiotics to prevent spontaneous bacterial peritonitis (SBP)</p></div><div id="niceng50er2.appk.s1.2"><h5>K1.1.2. Rationale for research recommendation</h5><p id="niceng50er2.appk.et1"><a href="/books/NBK595736/bin/niceng50er2-appk-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (97K)</span></p></div><div id="niceng50er2.appk.s1.3"><h5>K1.1.3. Modified PICO table</h5><p id="niceng50er2.appk.et2"><a href="/books/NBK595736/bin/niceng50er2-appk-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (104K)</span></p></div></div></div></div></div><div class="fm-sec"><div><p>Final version</p></div><div><p>Evidence reviews underpinning recommendation 1.3.6 to 1.3.8 and research recommendations in the NICE guideline</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="https://www.gov.scot/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="https://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2023.</div><div class="small"><span class="label">Bookshelf ID: NBK595736</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/37816102" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">37816102</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng50er2tab1"><div id="niceng50er2.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICOS inclusion criteria</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab1_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adults with liver cirrhosis and ascites, who were undergoing prophylactic treatment with antibiotics to prevent spontaneous bacterial peritonitis.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any of the following treatments, either alone or in combination:<ul><li class="half_rhythm"><div>Cephalosporins.</div></li><li class="half_rhythm"><div>Quinolones.</div></li><li class="half_rhythm"><div>Folic acid synthesis inhibitors.</div></li><li class="half_rhythm"><div>Rifaximin.</div></li><li class="half_rhythm"><div>Other classes of antibiotics.</div></li></ul></td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Each other</div></li><li class="half_rhythm"><div>No active intervention</div></li></ul>
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</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>Primary</b>
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<ul><li class="half_rhythm"><div>All-cause mortality at maximal follow-up (time to death).</div></li><li class="half_rhythm"><div>Health-related quality of life using a validated scale, at maximal follow-up</div></li><li class="half_rhythm"><div>Serious adverse events (during or within six months after cessation of intervention)</div></li></ul>
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</p>
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<p>
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<b>Secondary</b>
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<ul><li class="half_rhythm"><div>Any adverse events.</div></li><li class="half_rhythm"><div>Liver transplantation (time to liver transplantation at maximal follow-up).</div></li><li class="half_rhythm"><div>Time to development of spontaneous bacterial peritonitis</div></li><li class="half_rhythm"><div>Number of decompensation episodes (maximal follow-up)</div></li></ul>
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</p>
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</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study type</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">See <a href="#niceng50er2.s1.1.3">section 1.1.3</a></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng50er2tab2"><div id="niceng50er2.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the effectiveness evidence</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_niceng50er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study details</th><th id="hd_h_niceng50er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><th id="hd_h_niceng50er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</th><th id="hd_h_niceng50er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison</th><th id="hd_h_niceng50er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng50er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of bias</th></tr></thead><tbody><tr><td headers="hd_h_niceng50er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<a class="bibr" href="#niceng50er2.ref1" rid="niceng50er2.ref1">Komolafe et al 2020</a>
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</p>
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<p>Study type: Network Meta-analysis</p>
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<p>N= 23 studies</p>
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</td><td headers="hd_h_niceng50er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Randomised clinical trials with adults with liver cirrhosis, who were undergoing prophylactic treatment to prevent spontaneous bacterial peritonitis.</p>
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<p><b>Exclusion</b>: trials in which participants had previously undergone liver transplantation, or were receiving antibiotics for treatment of spontaneous bacterial peritonitis or other purposes, for example, treatment of hepatic encephalopathy.</p>
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</td><td headers="hd_h_niceng50er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any of the following different antibiotic interventions either alone or in combination:<ul><li class="half_rhythm"><div>Cephalosporins</div></li><li class="half_rhythm"><div>Quinolones</div></li><li class="half_rhythm"><div>Folic acid synthesis inhibitors</div></li><li class="half_rhythm"><div>Rifaximin</div></li><li class="half_rhythm"><div>Other classes of antibiotics</div></li></ul></td><td headers="hd_h_niceng50er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Each other or ‘no active intervention’ (either placebo or no antibiotic treatment),</td><td headers="hd_h_niceng50er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>Primary outcomes</b>
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<ul><li class="half_rhythm"><div>All-cause mortality at maximal follow-up (time to death).</div></li><li class="half_rhythm"><div>Health-related quality of life using a validated scale at maximal follow-up.</div></li><li class="half_rhythm"><div>Serious adverse events (during or within six months after cessation of intervention).<ul class="circle"><li class="half_rhythm"><div>Proportion of people with one or more serious adverse event.</div></li><li class="half_rhythm"><div>Number of serious adverse events per participant.</div></li></ul></div></li></ul>
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</p>
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<p>
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<b>Secondary outcomes</b>
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<ul><li class="half_rhythm"><div>Any adverse events (during or within six months after cessation of intervention) – as above</div></li><li class="half_rhythm"><div>Time to liver transplantation (maximal follow-up).</div></li><li class="half_rhythm"><div>Time to development of spontaneous bacterial peritonitis (however, defined by study authors at maximal follow-up)<ul class="circle"><li class="half_rhythm"><div>According to definitions used for spontaneous bacterial peritonitis.</div></li><li class="half_rhythm"><div>Symptomatic spontaneous bacterial peritonitis.</div></li></ul></div></li><li class="half_rhythm"><div>Number of decompensation episodes (maximal follow-up).</div></li></ul>
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</p>
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<p>
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<b>Exploratory outcomes</b>
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<ul><li class="half_rhythm"><div>Length of hospital stay (all hospital admissions until maximal follow-up)</div></li><li class="half_rhythm"><div>Number of days of lost work (in people who work) (maximal follow-up).</div></li><li class="half_rhythm"><div>Treatment costs (including the cost of the treatment and any resulting complications).</div></li></ul>
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</p>
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</td><td headers="hd_h_niceng50er2.tab2_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Risk of bias: <b>Low</b></p>
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<p>Directness: <b>Indirect</b></p>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng50er2tab3"><div id="niceng50er2.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng50er2.tab3_1_1_1_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis</th></tr><tr><th headers="hd_h_niceng50er2.tab3_1_1_1_1" id="hd_h_niceng50er2.tab3_1_1_2_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
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<p>Patient or population: people with liver cirrhosis</p>
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<p>Settings: secondary or tertiary care</p>
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<p>Intervention: various interventions</p>
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<p>Comparison: no active intervention</p>
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<p>Follow-up period: 1–12 months</p>
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</th></tr><tr><th headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" id="hd_h_niceng50er2.tab3_1_1_3_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><th headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" id="hd_h_niceng50er2.tab3_1_1_3_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Relative effect (95% CrI)</th><th headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1" id="hd_h_niceng50er2.tab3_1_1_3_3" colspan="3" rowspan="1" style="text-align:left;vertical-align:top;">Anticipated absolute effect<sup>*</sup> (95% CrI)</th><th headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" id="hd_h_niceng50er2.tab3_1_1_3_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Certainty of evidence</th></tr><tr><th headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3" id="hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No active intervention</th><th headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3" id="hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Various interventions</th><th headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3" id="hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Difference</th></tr></thead><tbody><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>All-cause mortality</b>
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</p>
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<p>Total studies: 17</p>
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<p>Total participants: 2169</p>
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</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>No active intervention</b>
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</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Reference</b>
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</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>Rifaximin</b>
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</p>
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<p>(3 RCTs, 479 participants)</p>
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</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>HR 0.57</b>
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</p>
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<p>(0.33 to 1.00)</p>
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<p>
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<b>Network estimate</b>
|
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</p>
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</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>184 per 1000</b>
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</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
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<b>105 per 1000</b>
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</p>
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<p>(61 to 184)</p>
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</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>
|
|
<b>79 fewer per 1000</b>
|
|
</p>
|
|
<p>(123 fewer to 0 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin</b>
|
|
</p>
|
|
<p>(4 RCTs, 546 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.74</b>
|
|
</p>
|
|
<p>(0.49 to 1.09)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>184 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>136 per 1000</b>
|
|
</p>
|
|
<p>(90 to 201)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>48 fewer per 1000</b>
|
|
</p>
|
|
<p>(94 fewer to 17 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Ciprofloxacin</b>
|
|
</p>
|
|
<p>(3 RCTs, 255 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.61</b>
|
|
</p>
|
|
<p>(0.31 to 1.16)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>184 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>113 per 1000</b>
|
|
</p>
|
|
<p>(57 to 213)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>71 fewer per 1000</b>
|
|
</p>
|
|
<p>(126 fewer to 29 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Sulfamethoxazole +trimethoprim</b>
|
|
</p>
|
|
<p>(1 RCT, 60 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.47</b>
|
|
</p>
|
|
<p>(0.20 to 1.00)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>184 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>85 per 1000</b>
|
|
</p>
|
|
<p>(38 to 184)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>98 fewer per 1000</b>
|
|
</p>
|
|
<p>(146 fewer to 0 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin +rifaximin</b>
|
|
</p>
|
|
<p>(no direct RCT)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.40</b>
|
|
</p>
|
|
<p>(0.12 to 1.17)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>184 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>73 per 1000</b>
|
|
</p>
|
|
<p>(22 to 215)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>111 fewer per 1000</b>
|
|
</p>
|
|
<p>(161 fewer to 32 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rufloxacin</b>
|
|
</p>
|
|
<p>(no direct RCT)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 1.45</b>
|
|
</p>
|
|
<p>(0.27 to 8.21)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>184 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>265 per 1000</b>
|
|
</p>
|
|
<p>(50 to 1000)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>82 more per 1000</b>
|
|
</p>
|
|
<p>(133 fewer to 816 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Health-related quality of life</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">None of the trials reported this outcome.</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Serious adverse events (proportion of participants with one or more serious adverse event)</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">None of the trials with no active intervention as control group reported this outcome.</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Serious adverse events (number of serious events per participant)</b>
|
|
</p>
|
|
<p>Total studies: 2</p>
|
|
<p>Total participants: 353</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>No active intervention</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Reference</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rifaximin</b>
|
|
</p>
|
|
<p>(2 RCTs, 353 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 1.66</b>
|
|
</p>
|
|
<p>(0.98 to 2.90)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>132 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>219 per 1000</b>
|
|
</p>
|
|
<p>(129 to 383)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>87 more per 1000</b>
|
|
</p>
|
|
<p>(3 fewer to 251 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Any adverse events (proportion of participants with one or more adverse event)</b>
|
|
</p>
|
|
<p>Total studies: 3</p>
|
|
<p>Total participants: 631</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>No active intervention</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Reference</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rifaximin</b>
|
|
</p>
|
|
<p>(1 RCT, 299 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>OR 1.01</b>
|
|
</p>
|
|
<p>(0.00 to 853.21)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>799 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>800 per 1000</b>
|
|
</p>
|
|
<p>(5 to 1000)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>1 more per 1000</b>
|
|
</p>
|
|
<p>(201 fewer to 201 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin</b>
|
|
</p>
|
|
<p>(no direct RCT)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>OR 11.85</b>
|
|
</p>
|
|
<p>(0.01 to 263,023.85)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>799 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>979 per 1000</b>
|
|
</p>
|
|
<p>(26 to 1000)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>180 more per 1000</b>
|
|
</p>
|
|
<p>(201 fewer to 201 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Any adverse events (number of events per participant)</b>
|
|
</p>
|
|
<p>
|
|
<b>(Only direct estimates presented as there was evidence of inconsistency in the network meta-analysis involving the main interventions being compared in this review)</b>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>No active intervention</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Reference</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rifaximin</b>
|
|
</p>
|
|
<p>(3 RCTs, 418 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 1.15</b>
|
|
</p>
|
|
<p>(0.98 to 1.34)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>531 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>609 per 1000</b>
|
|
</p>
|
|
<p>(522 to 710)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>78 more per 1000</b>
|
|
</p>
|
|
<p>(9 fewer to 169 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin</b>
|
|
</p>
|
|
<p>(4 RCTs, 546 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.74</b>
|
|
</p>
|
|
<p>(0.59 to 0.94)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>531 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>393 per 1000</b>
|
|
</p>
|
|
<p>(312 to 498)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>138 fewer per 1000</b>
|
|
</p>
|
|
<p>(219 fewer to 33 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Ciprofloxacin</b>
|
|
</p>
|
|
<p>(3 RCT; 255 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.72</b>
|
|
</p>
|
|
<p>(0.49 to 1.05)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>531 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>384 per 1000</b>
|
|
</p>
|
|
<p>(261 to 555)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>152 fewer per 1000</b>
|
|
</p>
|
|
<p>(270 fewer to 24 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Sulfamethoxazole + trimethoprim</b>
|
|
</p>
|
|
<p>(1 RCT, 60 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.19</b>
|
|
</p>
|
|
<p>(0.02 to 0.81)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>531 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>102 per 1000</b>
|
|
</p>
|
|
<p>(13 to 431)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>138 fewer per 1000</b>
|
|
</p>
|
|
<p>(219 fewer to 33 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Liver transplantation</b>
|
|
</p>
|
|
<p>Total studies: 3</p>
|
|
<p>Total participants: 260</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>No active intervention</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Reference</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin</b>
|
|
</p>
|
|
<p>(1 RCT, 68 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.93</b>
|
|
</p>
|
|
<p>(0.31 to 3.44)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>182 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>168 per 1000</b>
|
|
</p>
|
|
<p>(56 to 625)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>14 fewer per 1000</b>
|
|
</p>
|
|
<p>(126 fewer to 443 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Ciprofloxacin</b>
|
|
</p>
|
|
<p>(no direct RCT)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.62</b>
|
|
</p>
|
|
<p>(0.12 to 3.31)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>182 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>113 per 1000</b>
|
|
</p>
|
|
<p>(22 to 602)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>69 fewer per 1000</b>
|
|
</p>
|
|
<p>(160 fewer to 420 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Sulfamethoxazole + trimethoprim</b>
|
|
</p>
|
|
<p>(no direct RCT)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 2.62</b>
|
|
</p>
|
|
<p>(0.62 to 11.91)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>182 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>477 per 1000</b>
|
|
</p>
|
|
<p>(114 to 1000)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>295 more per 1000</b>
|
|
</p>
|
|
<p>(68 fewer to 818 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Spontaneous bacterial peritonitis (as per definition used for spontaneous bacterial peritonitis)</b>
|
|
</p>
|
|
<p>Total studies: 15</p>
|
|
<p>Total participants: 1504</p>
|
|
<p>
|
|
<b>(Only direct estimates presented as there was evidence of inconsistency in the network meta-analysis involving the main interventions being compared in this review)</b>
|
|
</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>No active intervention</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Reference</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rifaximin</b>
|
|
</p>
|
|
<p>(2 RCTs, 106 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 7.80</b>
|
|
</p>
|
|
<p>(0.13 to 4647.11)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>140 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>1000 per 1000</b>
|
|
</p>
|
|
<p>(19 to 1000)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>860 more per 1000</b>
|
|
</p>
|
|
<p>(121 fewer to 860 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin</b>
|
|
</p>
|
|
<p>(3 RCTs, 255 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.16</b>
|
|
</p>
|
|
<p>(0.00 to 1.56)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>140 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>23 per 1000</b>
|
|
</p>
|
|
<p>(0 to 219)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>117 fewer per 1000</b>
|
|
</p>
|
|
<p>(140 fewer to 79 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Ciprofloxacin</b>
|
|
</p>
|
|
<p>(3 RCTs, 255 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.56</b>
|
|
</p>
|
|
<p>(0.02 to 60.64)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>140 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>78 per 1000</b>
|
|
</p>
|
|
<p>(2 to 1000)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>62 fewer per 1000</b>
|
|
</p>
|
|
<p>(138 fewer to 860 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Sulfamethoxazole + trimethoprim</b>
|
|
</p>
|
|
<p>(1 RCT, 60 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR not estimable</b>
|
|
</p>
|
|
<p>Direct estimate</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>140 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Not estimable</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Not estimable</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1 hd_h_niceng50er2.tab3_1_1_3_2 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1 hd_h_niceng50er2.tab3_1_1_4_2 hd_h_niceng50er2.tab3_1_1_4_3 hd_h_niceng50er2.tab3_1_1_3_4" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Number of decompensation episodes (per participant)</b>
|
|
</p>
|
|
<p>Total studies: 8</p>
|
|
<p>Total participants: 1275</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>No active intervention</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Reference</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin + neomycin</b>
|
|
</p>
|
|
<p>(1 RCT, 22 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.06</b>
|
|
</p>
|
|
<p>(0.00 to 0.33)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>459 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>25 per 1000</b>
|
|
</p>
|
|
<p>(1 to 152)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>434 fewer per 1000</b>
|
|
</p>
|
|
<p>(458 fewer to 307 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin + rifaximin</b>
|
|
</p>
|
|
<p>(no direct RCT)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.33</b>
|
|
</p>
|
|
<p>(0.04 to 1.40)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>459 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>151 per 1000</b>
|
|
</p>
|
|
<p>(19 to 643)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>308 fewer per 1000</b>
|
|
</p>
|
|
<p>(440 fewer to 184 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rifaximin</b>
|
|
</p>
|
|
<p>(3 RCTs, 575 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.61</b>
|
|
</p>
|
|
<p>(0.46 to 0.80)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>459 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>280 per 1000</b>
|
|
</p>
|
|
<p>(209 to 365)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>179 fewer per 1000</b>
|
|
</p>
|
|
<p>(250 fewer to 94 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Norfloxacin</b>
|
|
</p>
|
|
<p>(3 RCTs, 439 participants)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.81</b>
|
|
</p>
|
|
<p>(0.58 to 1.12)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>459 per 1000</b>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>372 per 1000</b>
|
|
</p>
|
|
<p>(268 to 515)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_3 hd_h_niceng50er2.tab3_1_1_4_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>87 fewer per 1000</b>
|
|
</p>
|
|
<p>(192 fewer to 56 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab3_1_1_1_1 hd_h_niceng50er2.tab3_1_1_2_1 hd_h_niceng50er2.tab3_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>*</dt><dd><div id="niceng50er2.tab3_1"><p class="no_margin">Anticipated absolute effect. Anticipated absolute effect compares two risks by calculating the difference between the risks of the intervention group with the weighted median risk of the control group.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>CrI:</b> credible interval; <b>HR:</b> hazard ratio; <b>OR:</b> odds ratio; <b>RCT:</b> randomised clinical trial.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">GRADE Working Group grades of evidence</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>High certainty:</b> we are very confident that the true effect lies close to that of the estimate of the effect.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>Moderate certainty:</b> we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>Low certainty:</b> our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>Very low certainty:</b> we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng50er2.tab3_2"><p class="no_margin">Downgraded one level because the trial(s) included in the analysis was/were at high risk of bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng50er2.tab3_3"><p class="no_margin">Downgraded one level because the sample size was small.</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng50er2.tab3_4"><p class="no_margin">Downgraded one level because the credible intervals were wide (included clinical benefit and harms).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng50er2tab4"><div id="niceng50er2.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis – comparison by antibiotic</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng50er2.tab4_1_1_1_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis</th></tr><tr><th headers="hd_h_niceng50er2.tab4_1_1_1_1" id="hd_h_niceng50er2.tab4_1_1_2_1" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Patient or population: people with liver cirrhosis</p>
|
|
<p>Settings: secondary or tertiary care</p>
|
|
<p>Intervention: various interventions</p>
|
|
<p>Comparison: no active intervention</p>
|
|
<p>Follow-up period: 1–12 months</p>
|
|
</th></tr><tr><th headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1" id="hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1" id="hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Rifaximin</th><th headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1" id="hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Norfloxacin</th><th headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1" id="hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Ciprofloxacin</th></tr></thead><tbody><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>All-cause mortality</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>184 per 1000</b>
|
|
</p>
|
|
<p>
|
|
<b>(18.4%)</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.57</b>
|
|
</p>
|
|
<p>(0.33 to 1.00)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>79 fewer per 1000</b>
|
|
</p>
|
|
<p>(123 fewer to 0 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.74</b>
|
|
</p>
|
|
<p>(0.49 to 1.09)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>48 fewer per 1000</b>
|
|
</p>
|
|
<p>(94 fewer to 17 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.61</b>
|
|
</p>
|
|
<p>(0.31 to 1.16)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>71 fewer per 1000</b>
|
|
</p>
|
|
<p>(126 fewer to 29 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 479 participants (3 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 546 participants (4 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 255 participants (3 RCTs)</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Serious adverse events (number of events per participant)</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>132 per 1000</b>
|
|
</p>
|
|
<p>
|
|
<b>(13.2 per 100 participants)</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 1.66</b>
|
|
</p>
|
|
<p>(0.98 to 2.90)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>87 more per 1000</b>
|
|
</p>
|
|
<p>(3 fewer to 253 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 353 participants (2 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Any adverse events (proportion of participants with one or more adverse event)</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>799 per 1000</b>
|
|
</p>
|
|
<p>
|
|
<b>(79.9%)</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>OR 1.01</b>
|
|
</p>
|
|
<p>(0.00 to 853.21)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>1 more per 1000</b>
|
|
</p>
|
|
<p>(201 fewer to 201 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>OR 11.85</b>
|
|
</p>
|
|
<p>(0.01 to 263023.85)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>180 more per 1000</b>
|
|
</p>
|
|
<p>(201 fewer to 201 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 299 participants (1 RCT)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No direct RCTs</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Any adverse events (number of events per participant)</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>531 per 1000</b>
|
|
</p>
|
|
<p>
|
|
<b>(53.1 per 100 participants)</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 1.15</b>
|
|
</p>
|
|
<p>(0.98 to 1.34)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>78 more per 1000</b>
|
|
</p>
|
|
<p>(9 fewer to 169 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.74</b>
|
|
</p>
|
|
<p>(0.59 to 0.94)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>138 fewer per 1000</b>
|
|
</p>
|
|
<p>(219 fewer to 33 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.72</b>
|
|
</p>
|
|
<p>(0.49 to 1.05)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>152 fewer per 1000</b>
|
|
</p>
|
|
<p>(270 fewer to 24 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 418 participants (3 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 546 participants (4 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 255 participants (3 RCTs)</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Liver transplantation</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>182 per 1000</b>
|
|
</p>
|
|
<p>
|
|
<b>(18.2%)</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.93</b>
|
|
</p>
|
|
<p>(0.31 to 3.44)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>14 fewer per 1000</b>
|
|
</p>
|
|
<p>(126 fewer to 443 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.62</b>
|
|
</p>
|
|
<p>(0.12 to 3.31)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>69 fewer per 1000</b>
|
|
</p>
|
|
<p>(160 fewer to 420 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 68 participants (1 RCT)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No direct RCT</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Spontaneous bacterial peritonitis (as per definition used for spontaneous bacterial peritonitis)</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>140 per 1000</b>
|
|
</p>
|
|
<p>
|
|
<b>(14%)</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 7.80</b>
|
|
</p>
|
|
<p>(0.13 to 4647.11)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>860 more per 1000</b>
|
|
</p>
|
|
<p>(121 fewer to 860 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.16</b>
|
|
</p>
|
|
<p>(0.00 to 1.56)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>117 fewer per 1000</b>
|
|
</p>
|
|
<p>(140 fewer to 79 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>HR 0.56</b>
|
|
</p>
|
|
<p>(0.02 to 60.64)</p>
|
|
<p>
|
|
<b>Direct estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>62 fewer per 1000</b>
|
|
</p>
|
|
<p>(138 fewer to 860 more)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 106 participants (2 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 255 participants (3 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 255 participants (3 RCTs)</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Number of decompensation episodes (per participant)</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>459 per 1000</b>
|
|
</p>
|
|
<p>
|
|
<b>(45.9%)</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.61</b>
|
|
</p>
|
|
<p>(0.46 to 0.80)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>179 fewer per 1000</b>
|
|
</p>
|
|
<p>(250 fewer to 94 fewer)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>Rate ratio 0.81</b>
|
|
</p>
|
|
<p>(0.58 to 1.12)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>87 fewer per 1000</b>
|
|
</p>
|
|
<p>(192 fewer to 56 more)</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Very low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
c
|
|
</sup>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 575 participants (3 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 439 participants (3 RCTs)</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1 hd_h_niceng50er2.tab4_1_1_3_2 hd_h_niceng50er2.tab4_1_1_3_3 hd_h_niceng50er2.tab4_1_1_3_4" colspan="7" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Length of hospital stay</b>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>No active intervention</b>
|
|
</p>
|
|
<p>
|
|
<b>17.6 days</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>MD −8.29 days</b>
|
|
</p>
|
|
<p>(−11.09 to −5.50)</p>
|
|
<p>
|
|
<b>Network estimate</b>
|
|
</p>
|
|
</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>
|
|
<b>8.29 fewer days</b>
|
|
</p>
|
|
<p>(11.09 fewer to 5.5 fewer)</p>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>Low</b>
|
|
<sup>
|
|
a
|
|
</sup>
|
|
<sup>,</sup>
|
|
<sup>
|
|
b
|
|
</sup>
|
|
</td></tr><tr><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_3" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">—</td><td headers="hd_h_niceng50er2.tab4_1_1_1_1 hd_h_niceng50er2.tab4_1_1_2_1 hd_h_niceng50er2.tab4_1_1_3_4" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Based on 60 participants (1 RCT)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">
|
|
<b>CrI: credible interval; HR: hazard ratio; MD: mean difference; OR: odds ratio; RCT: randomised clinical trial.</b>
|
|
</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">
|
|
<b>GRADE Working Group grades of evidence</b>
|
|
</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>High certainty:</b> we are very confident that the true effect lies close to that of the estimate of the effect.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>Moderate certainty:</b> we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>Low certainty:</b> our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin"><b>Very low certainty:</b> we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng50er2.tab4_1"><p class="no_margin">Downgraded one level because the trial(s) included in the analysis was/were at high risk of bias.</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng50er2.tab4_2"><p class="no_margin">Downgraded one level because the sample size was small.</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng50er2.tab4_3"><p class="no_margin">Downgraded one level because the credible intervals were wide (included clinical benefit and harms).</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng50er2tab5"><div id="niceng50er2.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Health economic evidence profile: antibiotics vs placebo for preventing spontaneous bacterial peritonitis</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_niceng50er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study type</th><th id="hd_h_niceng50er2.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Applicability</th><th id="hd_h_niceng50er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Antibiotic</th><th id="hd_h_niceng50er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Drug costs per year</th><th id="hd_h_niceng50er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Threshold (cases averted to be cost saving)</th><th id="hd_h_niceng50er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk reduction in SBP</th><th id="hd_h_niceng50er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost saving</th></tr></thead><tbody><tr><td headers="hd_h_niceng50er2.tab5_1_1_1_1" rowspan="3" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<b>Threshold analysis</b>
|
|
</td><td headers="hd_h_niceng50er2.tab5_1_1_1_2" rowspan="3" colspan="1" style="text-align:left;vertical-align:middle;">Directly applicable</td><td headers="hd_h_niceng50er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ciprofloxacin</td><td headers="hd_h_niceng50er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£47</td><td headers="hd_h_niceng50er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 episode averted per 43.32 person years</td><td headers="hd_h_niceng50er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 case in every 16 people</td><td headers="hd_h_niceng50er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Yes</td></tr><tr><td headers="hd_h_niceng50er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rifaximin</td><td headers="hd_h_niceng50er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3,379</td><td headers="hd_h_niceng50er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Prevention with rifaximin costs more than SBP treatment (£2,024)</td><td headers="hd_h_niceng50er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk of developing SBP is higher than no active intervention</td><td headers="hd_h_niceng50er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cannot quantify</td></tr><tr><td headers="hd_h_niceng50er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Co-trimoxazole</td><td headers="hd_h_niceng50er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£89</td><td headers="hd_h_niceng50er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1 episode averted per 22.80 person years</td><td headers="hd_h_niceng50er2.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lack of clinical data</td><td headers="hd_h_niceng50er2.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cannot quantify</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng50er2tab6"><div id="niceng50er2.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Unit costs of antibiotics</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab6_lrgtbl__"><table><thead><tr><th id="hd_h_niceng50er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Resource</th><th id="hd_h_niceng50er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Daily dose</th><th id="hd_h_niceng50er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Unit costs</th><th id="hd_h_niceng50er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng50er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Norfloxacin</td><td headers="hd_h_niceng50er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">400mg</td><td headers="hd_h_niceng50er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Not available</td><td headers="hd_h_niceng50er2.tab6_1_1_1_4" rowspan="4" colspan="1" style="text-align:left;vertical-align:middle;">BNF (accessed March 2023)</td></tr><tr><td headers="hd_h_niceng50er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Ciprofloxacin</td><td headers="hd_h_niceng50er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">500mg</td><td headers="hd_h_niceng50er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">£1.28 for 10×500mg tablets</td></tr><tr><td headers="hd_h_niceng50er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Rifaximin</td><td headers="hd_h_niceng50er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">1100mg</td><td headers="hd_h_niceng50er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">£259.23 for 56×550mg tablets</td></tr><tr><td headers="hd_h_niceng50er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Co-trimoxazole</td><td headers="hd_h_niceng50er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">800 mg sulfamethoxazole/ 160 mg trimethoprim</td><td headers="hd_h_niceng50er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">£24.32 for 100×800/160mg tablets</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng50er2tab7"><div id="niceng50er2.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Management costs of SBP</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab7_lrgtbl__"><table><thead><tr><th id="hd_h_niceng50er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cost type</th><th id="hd_h_niceng50er2.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unit costs</th><th id="hd_h_niceng50er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_niceng50er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>7-day hospital stay: GBO3D (elective inpatient-excess bed days)</b>
|
|
</td><td headers="hd_h_niceng50er2.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,651.29</td><td headers="hd_h_niceng50er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Previous guideline, with cost inflation</td></tr><tr><td headers="hd_h_niceng50er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Tazocin (Piperacillin 4 g/tazobactam 500 mg IV every 8 hours for 5 days)</b>
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</td><td headers="hd_h_niceng50er2.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£227.55</td><td headers="hd_h_niceng50er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">BNF (2023)</td></tr><tr><td headers="hd_h_niceng50er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Paracentesis</b>
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</td><td headers="hd_h_niceng50er2.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£82.51</td><td headers="hd_h_niceng50er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Previous guideline, with cost inflation</td></tr><tr><td headers="hd_h_niceng50er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Ultrasound (RD40Z: outpatient, ultrasound scan with duration of less than 20 minutes, without Contrast)</b>
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</td><td headers="hd_h_niceng50er2.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£62.39</td><td headers="hd_h_niceng50er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS Cost Collection 2019/2020</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng50er2tab8"><div id="niceng50er2.tab8" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK595736/table/niceng50er2.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng50er2.tab8_lrgtbl__"><table><thead><tr><th id="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Facciorusso, A., Papagiouvanni, I., Cela, M.
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et al (2019) Comparative Efficacy of Long-term Antibiotic Treatments in the Primary Prophylaxis of Spontaneous Bacterial Peritonitis. Liver international : official journal of the International Association for the Study of the Liver [<a href="https://pubmed.ncbi.nlm.nih.gov/30920712" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30920712</span></a>]
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</td><td headers="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Mucke, Marcus M, Mucke, Victoria T, Graf, Christiana
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et al (2020) Efficacy of Norfloxacin Prophylaxis to Prevent Spontaneous Bacterial Peritonitis: A Systematic Review and Meta-Analysis. Clinical and translational gastroenterology
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11(8): e00223 [<a href="/pmc/articles/PMC7431273/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7431273</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32955202" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32955202</span></a>]
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</td><td headers="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Pimentel, R; Gregorio, C; Figueiredo, P (2021) Antibiotic prophylaxis for prevention of spontaneous bacterial peritonitis in liver cirrhosis: systematic review. Acta gastro-enterologica Belgica
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84(2): 333–342 [<a href="https://pubmed.ncbi.nlm.nih.gov/34217185" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34217185</span></a>]
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</td><td headers="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Praharaj, D.L., Premkumar, M., Roy, A.
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et al (2022) Rifaximin Vs. Norfloxacin for Spontaneous Bacterial Peritonitis Prophylaxis: A Randomized Controlled Trial. Journal of Clinical and Experimental Hepatology
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12(2): 336–342 [<a href="/pmc/articles/PMC9077172/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9077172</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35535057" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35535057</span></a>]
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</td><td headers="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>- Duplicate reference</p>
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<p>
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<i>This is the final publication of data that was already included in the Komolafe NMA from a conference abstract (Praharaj 2017 in the Komolafe NMA).</i>
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</p>
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</td></tr><tr><td headers="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Soriano
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G, Guarner
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C, Teixido
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M, Such
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J, Barrios
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J, Enriguez
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J
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et al
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Selective intestinal decontamination prevents spontaneous bacterial peritonitis. Gastroenterology. 1991; 100(2):477–481. [<a href="https://pubmed.ncbi.nlm.nih.gov/1985045" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1985045</span></a>]
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</td><td headers="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">This study did not report data that could be fitted to the NMA and was therefore excluded</td></tr><tr><td headers="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Soni, Hariom, Kumar-M, Praveen, Sharma, Vishal
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et al (2020) Antibiotics for prophylaxis of spontaneous bacterial peritonitis: systematic review & Bayesian network meta-analysis. Hepatology international
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14(3): 399–413 [<a href="https://pubmed.ncbi.nlm.nih.gov/32266675" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32266675</span></a>]
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</td><td headers="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr><tr><td headers="hd_h_niceng50er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Wang, J., Liu, C., Song, P.
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et al (2019) Norfloxacin, ciprofloxacin, trimethoprim-sulfamethoxazole, and rifaximin for the prevention of spontaneous bacterial peritonitis: A network meta-analysis. European Journal of Gastroenterology and Hepatology
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31(8): 905–910 [<a href="https://pubmed.ncbi.nlm.nih.gov/31107737" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31107737</span></a>]
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</td><td headers="hd_h_niceng50er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">- Systematic review used as source of primary studies</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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