Intervention Review

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Antibiotics for acute laryngitis in adults

  1. Ludovic Reveiz1,*,
  2. Andrés Felipe Cardona2

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 28 MAR 2013

Assessed as up-to-date: 30 JAN 2013

DOI: 10.1002/14651858.CD004783.pub4


How to Cite

Reveiz L, Cardona AF. Antibiotics for acute laryngitis in adults. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD004783. DOI: 10.1002/14651858.CD004783.pub4.

Author Information

  1. 1

    Health Systems Based on Primary Health Care (HSS), Pan American Health Organization, Research Promotion and Development Team, Washington DC, USA

  2. 2

    Institute of Oncology, Fundación Santa Fe de Bogotá, Clinical and Translational Oncology Group, Bogotá, Cundinamarca, Colombia

*Ludovic Reveiz, Research Promotion and Development Team, Health Systems Based on Primary Health Care (HSS), Pan American Health Organization, 525, 23rd St, NW, Washington DC, 20037-2895, USA. mmreveiz@hotmail.com. lreveiz@yahoo.com.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions), comment added to review
  2. Published Online: 28 MAR 2013

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Characteristics of included studies [ordered by study ID]
Schalén 1985

MethodsRandomised, double-blind, controlled trial


ParticipantsAdult patients aged over 18 with a history of acute laryngitis defined as hoarseness associated with other symptoms of upper respiratory tract infection

Exclusion = patients with chronic relevant underlying diseases, symptoms of laryngitis for more than 3 weeks (chronic laryngitis) and antibiotic therapy within the preceding 2 weeks before diagnosis

N = 100
Penicillin V: n = 51
Placebo: n = 49
No drop-outs


InterventionsPenicillin V 0.8 g b.i.d for 5 days
Placebo


OutcomesObjective voice scores. No statistical difference was found between the 2 groups

Symptoms judged by the patients. No differences were found between the 2 groups

Bacteriological findings. The isolation rates of pathogens at the acute and at the follow-up visits after 1 and 2 weeks did not differ significantly between the 2 groups


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear risk"Double blind study". No mention of randomisation

Allocation concealment (selection bias)Unclear riskNo details mentioned

Blinding (performance bias and detection bias)
All outcomes
Unclear risk"Double blind". "Identical placebo". It was not clear who was blinded

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskInsufficient information to permit judgment of 'low risk' or 'high risk'

Incomplete outcome data (attrition bias)
All outcomes
Low riskNo drop-outs

Selective reporting (reporting bias)Unclear riskThe study protocol is not available

Other biasLow riskBaseline characteristics mentioned

Schalén 1993

MethodsRandomised, double-blind, controlled trial


ParticipantsAdult patients aged over 18 with history of acute laryngitis defined as hoarseness associated with other symptoms of upper respiratory tract infection

Exclusion = patients with chronic relevant underlying diseases, symptoms of laryngitis for more than 2 weeks, history of allergy or intolerance to erythromycin, pregnancy and antibiotic therapy within the preceding 2 weeks before diagnosis

N = 106
Penicillin V: n = 51
Placebo: n = 49
7 drop-outs


InterventionsErythromycin 500 mg b.i.d for 5 days
Placebo


OutcomesObjective voice scores. No statistical difference was found between the 2 groups

Symptoms judged by the patients. At 1 week there were significant differences in the severity of reported vocal symptoms as judged by the patients, comparing the erythromycin and placebo groups (P = 0.042). At 2 weeks significantly fewer complaints of cough were reported by the erythromycin group

Bacteriological findings. There was no difference between the 2 groups in the recovery rate of pathogens at 2 weeks


Notes


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear risk"Randomised"

Allocation concealment (selection bias)Unclear riskNo details mentioned

Blinding (performance bias and detection bias)
All outcomes
Low risk"Double blind". "Identical tablets". It was not clear if outcome assessors were blinded.

Blinding of participants and personnel (performance bias)
All outcomes
Unclear riskInsufficient information to permit judgment of 'low risk' or 'high risk'

Incomplete outcome data (attrition bias)
All outcomes
Unclear risk15% lost to follow-up. No reasons mentioned

Selective reporting (reporting bias)Unclear riskThe study protocol is not available

Other biasUnclear riskBaseline characteristics mentioned. The erythromycin group had a higher and more significant number of bacterial pathogens and M. catarrhalis was isolated from the nasopharynx in this group (P = 0.045 and P = 0.012, Fisher's exact test).

 
Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Schalén 1992A preliminary report of the erythromycin trial (Schalén 1993)