JURNAL READING

Stase Ilmu Kesehatan Keluarga

Universitas Muhammadiyah Yogyakarta

Kepaniteraan Klinik Bagian Ilmu Kedokteran Keluarga
Periode 51
Puskesmas Ngampilan Yogyakarta
Ranum, Kurnia, Gita, Anita, Restu, Amaro
 CRITICAL APPRAISAL

Gatifloxacin versus
chloramphenicol for
uncomplicated enteric fever:
an open-label, randomised,
controlled trial
Critical Appraisal
JUDUL TULISAN Gatifloxacin versus
chloramphenicol for
uncomplicated enteric fever: an
open-label, randomised,
controlled trial

PENULIS Amit Arjyal, Buddha Basnyat,

Samir Koirala, Abhilasha Karkey,
Sabina Dongol, Khrisna Kumar
Agrawaal, Nikki Shakya, Kabina
Shresta, Manish Sharma, Sanju
NAMA JURNAL, VOLUME, NOMORLama, Katsuri
& TAHUN Shrestha, James I
TERBIT
Campbell
Lancet Infect. Dis.. (2011); 21; 445-54
Critical Appraisal
Rumusan PICO
P I C O
(Patient/Probl (Intervention (Comparison) (Outcome)
em) )
Children and Gatifloxacin Chloramphenic Treatment
adults clinically (10 mg/kg) ol (75 mg/kg) failure
diagnosed with once a day for in four divided
enteric fever 7 days doses for 14
days
Critical Appraisal
A/ Are the results of the trial valid?
Screening Questions
1. Was the assignment of patients to
treatments randomised?
2. Was the randomisation
concealed?
3. Was the follow-up patients
sufficiently long and complete?
YES
Each enrolled patient was randomly
assigned to treatment with either
gatifloxacin tablets or chloramphenicol
capsules. (Page 447)
list NO
Masking was not possible because of the
different formulations and ways of giving
the two drugs (Page 447)
YES
Follow-up lasts for 6 months. Among 853
randomized, 844 was analyzed (low
Drop Out Rate). (Page446)
Critical Appraisal
4. Were all patients analyzed in groups NO
to which they were randomised? Among 853 randomized, 844 was
analyzed (low Drop Out Rate). (Page446)
5. Were paptients and clinicians kept NO
blind to treatment? Masking was not possible because of the
different formulations and ways of giving
the two drugs (Page 447)
6. Were the groups treated equally, YES
apart from the experiment The primary outcome was assessed in
treatment? all patients randomly allocated
treatment and reported separately for
culture-positive patients and for all
patients (INTRO)
7. Were the groups similar at the start YES
of the trial? Inclusion criteria for both group : patient
with fever for mote than 3 days who
were clinically diagnosed to have enteric
fever; who gave fully informed written
consent
Exclusion criteria also apply for both
group (Page 446)
Critical Appraisal
B/ Are the valid results of this randomised trial important?

Outcom Time to CER EER RRR ARR NNT

e Outcome
Kegagal 1. 0,08 1. 0,06 1. 0,25 1. 0,02 1. 50
an
terapi 95% Confidence Intervals:
Critical Appraisal
C/ Can you apply this valid, important evidence about therapy
in caring for your patient?
1. Do these results apply to your patient?
1a. Is your patient so different NO
from those in the study that its
results cannot apply?
1b. Is the treatment feasible in YES
your setting?
2. Are your patients values and preferences satisfied by the regimen
and its consequences?
2a. Do your patient and you have YES
a clear assessment of their values
and preferences?
2b. Are they met by this regimen YES
and its consequences?
Terimakasih