What's labelled Cochrane contains not always Cochrane
The publication of Craig J Currie et al. from the Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK, and Global Epidemiology, Pharmatelligence, Cardiff, UK, is not so intelligent as it wants to be.
1. Conclusions like "from 1991 to 2012, more than one in 10 first line antibiotic monotherapies for the selected infections were associated with treatment failure" mean in the publications reality that in 22 years of observation only 13.9 to 15.4 percent of antibiotic treatment failed. In the meantime 86.1 to 84.6 percent of the antibiotic treatment obviously succeeded instead.
2. When "overall failure rates increased by 12% over this period..." of 22 years this is an annual increase of 0.545 percent only.
In my opinion most of the British GP and Family Doctors did right with their targeting antibiotic treatment from 1991 until 2012. Nearly constant failure rates from 13.9 to 15.4 percent over such a long period instead of augmenting antibiotic resistance, increasing allergies e. g. against penicillin and amoxicillin, ß-lactamase active germs, less effectiveness of older antibiotics e.g. trimethoprim and tetracycline, non indicated ciprofloxacin therapy, and new multi-resistant germs like MRSA or others should be taken into consideration.
This seems to be a very undifferentiated BMJ-publication caricaturing the former idea of critical Cochrane investigation.
Competing interests:
No competing interests
21 October 2014
Thomas G. Schaetzler
Family Medicine Unit
Public GP-medical office/Fachpraxis Allgmeinmedizin
Rapid Response:
What's labelled Cochrane contains not always Cochrane
The publication of Craig J Currie et al. from the Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, UK, and Global Epidemiology, Pharmatelligence, Cardiff, UK, is not so intelligent as it wants to be.
1. Conclusions like "from 1991 to 2012, more than one in 10 first line antibiotic monotherapies for the selected infections were associated with treatment failure" mean in the publications reality that in 22 years of observation only 13.9 to 15.4 percent of antibiotic treatment failed. In the meantime 86.1 to 84.6 percent of the antibiotic treatment obviously succeeded instead.
2. When "overall failure rates increased by 12% over this period..." of 22 years this is an annual increase of 0.545 percent only.
In my opinion most of the British GP and Family Doctors did right with their targeting antibiotic treatment from 1991 until 2012. Nearly constant failure rates from 13.9 to 15.4 percent over such a long period instead of augmenting antibiotic resistance, increasing allergies e. g. against penicillin and amoxicillin, ß-lactamase active germs, less effectiveness of older antibiotics e.g. trimethoprim and tetracycline, non indicated ciprofloxacin therapy, and new multi-resistant germs like MRSA or others should be taken into consideration.
This seems to be a very undifferentiated BMJ-publication caricaturing the former idea of critical Cochrane investigation.
Competing interests: No competing interests