Methodology
The antibiotic resistance is considered to be one of the main worldwide public well-being issues as antibiotics are arranged for children offering with simple lower respiratory contagions. The researcher in this case conducted a randomised controlled trial study for determining the efficiency of any antibiotics in treating the condition (Peterson and Kaur 2018). It is stated that almost 2.8 million antibiotic resistant infection occur in every year (Schillaci et al. 2017). However, many medical conditions require the use of antibiotics such as in case of cancer therapy, diabetes, organ transplants and rheumatoid arthritis (Yelin and Kishony 2018). On the other hand, the critical assessment is considered to be the procedure of systematically examining the research for judging its value, trustworthiness and relevance in relation to a particular context (Accardi et al. 2016). The following paper will critically analyse a research study named- “Antibiotics for lower respiratory tract infection in children presenting in primary care in England (ARTIC PC): a double-blind, randomised, placebo-controlled trial” with the help of CASP tool.
Procedure
The researcher in this case included participants after taking proper consent from the parents and randomly assigned the participants in the two groups in the ratio of 1:1. The researcher also generated a computerized random number list which was provided by an independent statistician. The random block sizes of 2 to 4 packets were utilized and the investigators randomized and dispensed by selecting the next sequential number. The researcher in this case chose the amoxicillin drug as the first line of antibiotics for treating lower respiratory infection along with the current level of intermediate resistance which covers the susceptible organism. The researcher in this case provided a 7 days course to the children and the complete case report for analyzing the commodities along with the signs and symptoms and the seniority of symptom which is reported by the patient is also found to be analyzed which helps in reducing the bias in this study result. A proper note of the patient’s signs and symptoms were found to be noted by the parents during the course of treatment at least for one week which helped in understanding the severity of the symptoms. Information on the resources was collected by reviewing the major adverse event at a baseline of 28 days after randomisation and both the groups were treated equally which helped in analysing the effectiveness and utility of prescribing antibiotics among the children the chance of developing and divided resistance (Little et al. 2021).
Validity
The researcher in this case aimed at analyzing, determining and hypothesizing that amoxicillin helps in reducing the duration of moderately bad and undesirable symptoms among children suffering from non-pneumatic respiratory disease in primary care. The researcher in this case conducted the study with the help of randomized control trial design which is appropriate in this case as the study aimed at understanding the effectiveness of the amoxicillin intervention in lowering the severity of symptoms. The study population which was considered in this case included children due to long term suffering of pneumonia and hence the population included in the study is appropriate to understand the difference in the symptoms faced by the adult and the children. The factors which might include biases in the study findings include lack of consent of the participants, unmasking or lack of blinding of the participants which was appropriately followed in this case (Little et al. 2021).
Results
Discussion
The researcher in this case included a total number of 156 participants in the control group and that of 161 participants in the intervention group which was appropriate in this case. The results were presented in the form of tables which was a simple presentation and helped in understanding the utility of the intervention in curing the symptoms. No such difference has been found in terms of primary outcome between the two groups at 95% confidence interval (Little et al. 2021).
Outcome
The primary outcomes which were considered in this case and can be applied in the local population are- determination of the signs and symptoms, duration and effectiveness of the intervention. The secondary analysis considered the symptoms. The statistical analysis was done by the sample size calculation by using the proportion of sub-groups. The researcher also used cox regression and linear regression for determining the symptoms. The final analysis was done by the SPSS. The result can be considered by the policymaker for restricting the dose for lowering the incidence of antibiotic resistance. The safety of the treatment must be considered in other clinical settings as well (Little et al. 2021).
Results
Unclear, the researcher in this case failed in providing a clear research question but the aim of the study clearly addressed that the researcher in this case aimed at hypothesizing that amoxicillin lowers the period of discreetly bad indications in the children who are presented with any type of simple that is non-pneumonic symptoms (Doody and Bailey 2016). The research in this case clearly addresses the population which are children suffering from pneumonia and the intervention is also clearly highlighted that is prescription of Amoxicillin in reducing the symptom of pneumonia among the children and thereby preventing the risk of developing lower tract infection (Hunt et al. 2018). The researcher in this case clearly highlighted the population, intervention and outcomes. It is stated that a proper research question helps in investigating the identified issue by determining the population and having a proper outcome of interest (Ratan et al. 2019).
Yes, the researcher in this case performed the randomized control trial study for determining the effectiveness of Amoxicillin in lowering the duration of bad symptoms of chest infection among the children in comparison to the control group. The researcher in this case performed the study as a double randomization technique where the children and the parents who gave consent for the study were randomly assigned into the group in 1: 1 ratio in either treatment group or control group (Li et al. 2016). The treatment assessment was fully masked to the participants and the investigator which helped in increasing the validity and credibility of the study by lowering the chance of developing personal bias to the characteristics demanded or the effect of placebo (Hariton and Locascio 2018). Yes, the researcher in this case made the allocation in an effective way where the treatment assignment was masked to both the participants and the process helped in enhancing the credibility and validity of the study.
Discussion
Yes, the researcher in this case located the participant in the ratio of 1:1 and the participants were arbitrarily allocated into the collection either in the control collection when no such amoxicillin was provided and in the control group where the amoxicillin was provided to the children (Akbarpour and Nikzad 2020). The researcher in this case followed the process of true randomization where each of the participants has an equal chance of participating in this study and is assigned to any of the groups (Lee et al. 2020).
Yes, the researcher in the study clearly addressed that the participants and the researcher were fully masked. The masking of the participants helps in lowering the personal bias and the intervention characteristic fails in impacting the result of the study. The masking of the researcher helped in lowering the chance of observation bias and hence, it helped in increasing the effectiveness of the study outcome (Drye 2019).
No, not all the participants were found to be present at the end of the study. It is determined that a total number of 1460 patients were assessed for understanding the eligibility and out of them 438 patients were randomly assigned into two groups where 216 participants were allocated in the control collection and 222 members were located in the intercession group and received antibiotics. However, in both the control and the intervention group the total number of participants failed in receiving proper treatment in both the group and as a result during the process 55 participants were found to lost during the follow-up process from the control group and that of 60 participants were found to lost from the intervention group as a result a total number of 156 participants were found to complete the experiment from the control group and that of 161 participants completed the experiment from the intervention group. The loss of participants during the follow-up process leads to incomplete study results and ultimately develops a chance of bias on the investigation of study by lowering the effectiveness of the determined outcome (Little et al. 2021).
Yes, the participants and the researcher were completely blind to the treatment which helped in lowering the study bias. The implementation of the blinding process helps in lowering the chance of developing bias and it also helps in avoiding selection bias.
Yes, the groups which were considered at the beginning of the study were similar at the end of the study. The researcher in this case, included appropriate participants who aimed at analyzing the impact of amoxicillin among the children in comparison to the control group suffering from various symptom. The researcher in this case included children and parents after taking proper consent (Little et al. 2021).
Yes, the groups were also similar at the beginning where the children suffering from infectious symptoms were included in the study. The researcher aimed at focusing the issue which is to determine the antibiotic resistance of Amoxicillin among the children (Little et al. 2021).
Yes, both the groups were equally treated in this case. The participants were treated with amoxicillin in 50mg/kg for 7 days and that control group received usual course of medication for 7days and the effects were analyzed. The groups and the symptom of the conditions were evaluated for 28days which is equal for both the groups.
Limitations
The primary outcome which was measured in this case was the duration of the patient symptoms which was rated as bad or worst and the record has been done in a validated way up to 28days until the symptom resolved. The primary outcome in this case matched the parental concern in this case.
Yes, the researcher followed the confidence interval of 95% and performed the statistical analysis.
Yes, the result can be applied in the local population. The result will help in determining the antibiotic resistance severity and the duration of the drug course which increases the severity of the antibiotic resistance. The result will be helpful for adapting alternative courses and lowering the chance of prescribing antibiotic.
Yes, all the clinical important outcomes were considered in the study which can be used for lowering the incidence of antibiotic resistance (Al-Jundi and Sakka 2017).
The study participants must be increased as the researcher included lower proportion of the participants which might have impacted the study result (Little et al. 2021).
Yes, the researcher had enough participants for concluding the study result. The researcher highlighted that balancing the threat which is posted by resistance of antibiotics, a 3-day alteration in indication was arbitrated by the patient and community participation side and decided with the detective team to be clinically important sufficient to permit treatment. The researcher in this case projected that 938 children were essential for α=0·01, 90% power, 80% follow-up for detecting an HR of 1-7 in order to measure the primary consequence among the five equally prioritised clinical subgroups. The researcher highlighted that a sample size control was studied after arrangement with the funder, experimental direction-finding group, and information monitoring security committee founded on the two indication such as from the systematic review of determining the abnormal chest signs and determining the portion of sub-groups observed. The researcher utilised the traditional approach for powering the sub-group sizes and adjusting the α for multiple subgroups.
The researcher in this case presented the study in form of tables and graphics which helped in determining the study results apparently. The result of the study highlighted that in between November 9 2016 to March 7 2022, a total number of 432 members were comprised randomly in the antibiotic and control group and the comprehensive data for indication duration was obtainable for among 73% of the patients and the missing data were imported for the primary analysis (Little et al. 2021).
It is determined that no such P-value is mentioned in this case. However, the study highlighted that median duration of abstemiously washed or bad indications was similar between the group (5dyas [IQR 4-11] in the antibiotic group versus 6 days [4 – 15] in the control group. The hazard ratio was 1- 13 at 95% CI 0.90- 1.42, which clearly determines that no such difference is observed in the primary outcome amongst the treatment group and the control group in the five days of prespecified interference (Little et al. 2021).
The result of the study clearly highlighted the fact that antibiotics are unlikely to have a clinical importance in reducing the burden of uncomplicated symptoms and lowering the side effects of any infection (Munita and Arias 2016). Similarly, the antibiotics will be prescribed and the clinicians must provide proper safety advice to the patients especially the parents in this case and lower the incidence of prescribing antibiotics for most of the children suffering from chest infection. All the factors were analyzed in the study and the study can be applied in general population including both children and adults and hence, it will help in lowering the public threat such as eradicating the incidence of antibiotic resistance (Kapoor et al. 2017).
Conclusion
The above paper critically analysed the research article. The antibiotic resistance occurs when micro-organisms are able to defend the drugs which can usually prescribed for eradicating the same. It is stated that almost 2.8 million antibiotic resistant infection occur in every year. The critical assessment is considered to be the procedure of systematically examining the research for judging its value, trustworthiness and relevance in relation to a particular context. Amoxicillin in reducing the symptom of pneumonia among the children and thereby preventing the risk of developing lower tract infection. The researcher in this case clearly highlighted the population, intervention and outcomes. Lastly, the study highlighted about the effectiveness of the result.
References
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