Meta-analysis of parenteral clindamycin dosing regimens Rovers J P, Ilersich A L, Einarson T R Authors' objectives To evaluate the differences in clinical outcomes for 2 different dosages of parenteral clindamycin, 600 and 900 mg, both 8 hourly, in adult patients with intra-abdominal infection or female pelvic infection. Searching MEDLINE, EMBASE and International Pharmaceutical Abstracts were searched for English language articles describing clindamycin use in humans. Additional sources were personal and drug information centre files, and the reference lists of retrieved papers. Study selection Study designs of evaluations included in the review Comparative studies of both open and blind design were included. Specific interventions included in the review Parenteral dosages of clindamycin, 600 mg or 900 mg 8 hourly. Comparable treatments included any other regimen of clindamycin or equivalent antibiotic therapy. Participants included in the review Adult patients with either intra-abdominal infection or female pelvic infection were included. Exclusions: seriously ill patients who were expected to die, patients aged less than 18 years, studies including exclusively elderly patients and those receiving clindamycin for infection prophylaxis. Outcomes assessed in the review Cure, failure, and success were assessed. Cure was defined as the resolution of all clinical signs and symptoms of infection within 96 hours of beginning clindamycin therapy. Failure was defined as the continuation of clinical signs and symptoms of infection after 96 hours of beginning clindamycin therapy. Success rates were calculated from the pooling of data from cured cases and improved cases, where the latter group showed clinical progress that was insufficient for inclusion into the cure category. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the authors performed the selection. Assessment of study quality The authors do not report the method used to assess validity, or how the validity assessment was performed. [A: Quality assessment was not performed.] Data extraction Two investigators extracted the data independently, but unblinded, and later reconciled any discrepancies. Methods of synthesis How were the studies combined? A weighted success rate was calculated (see Other Publications of Related Interest no.1) for each dosage regimen of clindamycin, adjusted for use with a single proportion. Rates of clinical outcomes between dosage regimens for each clinical indication were compared using the non-parametric Mann-Whitney U test. p<0.05 represented statistical Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright © 2018 University of York Page: 1 / 4