Study designs of evaluations included in the review
Randomised controlled trials (RCTs), comparative trials and case series were eligible for inclusion. Case reports and series with fewer than 5 participants were excluded.
Specific interventions included in the review
Studies of heparin in addition to proper antibiotic use as therapy for septic thrombophlebitis were eligible for inclusion. The included studies used standard or low molecular weight heparin, administered intravenously for septic thrombophlebitis in pelvic veins or subcutaneously for veins at other body sites. Where stated, heparin was added to the antimicrobial treatment regimen either on clinical suspicion of thrombophlebitis or a few days later when antibiotic therapy alone was deemed to have failed. A wide range of antibiotics was used, all given intravenously. The commonly used antibiotics were cephalothin, oxacillin, combination of ampicillin/gentamycin/clindamycin, and vancomycin.
Participants included in the review
Studies of patients with deep vein septic thrombophlebitis were eligible for inclusion. Studies of patients with thrombophlebitis of superficial veins were excluded. The participants in the included studies had a wide range of disorders and included women who were postpartum or post gynaecological surgery, children with otitis media or undisclosed disorders, intravenous drug users and patients with infections of the head and neck. The range of affected body sites included pelvic, internal jugular, femoral, iliac, cerebral and subclavian veins, and the inferior vena cava. A minority of studies confirmed the diagnosis by radiological investigation in all participants.
Outcomes assessed in the review
Studies that reported the effectiveness and toxicity of heparin and/or mortality rates were eligible for inclusion. The outcomes reported were mortality, time to defervescence (abatement of fever), need for surgical intervention and adverse effects.
How were decisions on the relevance of primary studies made?
The authors did not clearly state how the papers were selected for the review, or how many reviewers performed the selection.