A Cochrane review [Abstract] 1 on the benefits of antibiotics for sore throat included 27 studies with a total of 12 835 cases of sore throat. Ten studies (n=5 147) reported on acute glomerulonephritis as an end point. There was a trend for protection against acute glomerulonephritis from antibiotics: cases of acute glomerulonephritis occurred only in the control group, which suggests that antibiotics conferred protection, but there were altogether only two cases. A very wide 95% confidence interval, (OR = 0.07; 95% CI 0.00-1.32) precludes the claim that antibiotics protect sore throat sufferers from acute glomerulonephritis.
Comment: The quality of evidence is downgraded by imprecise results (few outcome events), by severe study limitations and by indirectness (quick diagnosis of group A streptococci was not attempted in most trials, and the treatment was not confined to patients with positive results).
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