What do systematic reviews say?

Antibiotics vs antibiotics alone

It is very uncertain whether antibiotics changes neonatal deaths compared with antibiotics (very low certainty).

• Antibiotic regimens for management of intra‐amniotic infection 2014 · Cochrane Headline outcomes only
  RR 1.39 [0.24, 8.06]
  1 study · 133 participants
  Very low

Antibiotics vs antibiotics alone

Antibiotics showed no clear difference in neonatal sepsis compared with antibiotics (low certainty).

• Antibiotic regimens for management of intra‐amniotic infection 2014 · Cochrane Headline outcomes only
  RR 1.07 [0.4, 2.86]
  2 studies · 163 participants
  Low

Antibiotics vs antibiotics alone

Antibiotics showed no clear difference in respiratory distress syndrome compared with antibiotics (low certainty).

• Antibiotic regimens for management of intra‐amniotic infection 2014 · Cochrane Headline outcomes only
  RR 1.69 [0.42, 6.78]
  1 study · 125 participants
  Low

Antibiotics vs antibiotics alone

• Antibiotic regimens for management of intra‐amniotic infection 2014 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 125 participants
  Low

Antibiotics vs antibiotics alone

• Antibiotic regimens for management of intra‐amniotic infection 2014 · Cochrane Headline outcomes only
  no estimate extracted
  0 studies · 0 participants
  GRADE not reported

Antibiotics vs antibiotics alone

Antibiotics showed no clear difference in treatment failure (endometritis) compared with antibiotics (low certainty).

• Antibiotic regimens for management of intra‐amniotic infection 2014 · Cochrane Headline outcomes only
  RR 0.86 [0.27, 2.7]
  2 studies · 163 participants
  Low

Summary of findings: Inhaled antibiotics vs IV antibiotics

It is very uncertain whether summary of findings: Inhaled antibiotics changes need for additional IV or oral antibiotics compared with IV antibiotics (very low certainty).

• Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis 2022 · Cochrane Headline outcomes only
  RR 6.11 [0.33, 111.71]
  1 study · 18 participants
  Very low

Summary of findings table ‐ Delayed antibiotics vs no antibiotics

Summary of findings table ‐ Delayed antibiotics probably leads to higher patient satisfaction: delayed (prescription collection) versus no… compared with no antibiotics (moderate certainty).

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  OR 1.45 [1.08, 1.96]
  5 studies · 1523 participants
  Moderate

Summary of findings table ‐ Delayed antibiotics vs no antibiotics

Summary of findings table ‐ Delayed antibiotics showed no clear difference in reconsultation rate: delayed (all strategies) versus no antibiotics compared with no antibiotics (moderate certainty).

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  OR 0.83 [0.46, 1.52]
  2 studies · 584 participants
  Moderate

Summary of findings table ‐ Delayed antibiotics vs no antibiotics

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 674 participants
  Moderate

Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics

Summary of findings table ‐ Delayed antibiotics probably leads to lower antibiotic use: delayed (all strategies) versus immediate antibiotics compared with immediate antibiotics (moderate certainty).

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  OR 0.03 [0.01, 0.07]
  8 studies · 2257 participants
  Moderate

Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics

Summary of findings table ‐ Delayed antibiotics showed no clear difference in patient satisfaction: delayed (all strategies) versus immediate… compared with immediate antibiotics (moderate certainty).

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  OR 0.77 [0.45, 1.29]
  7 studies · 1927 participants
  Moderate

Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics

Summary of findings table ‐ Delayed antibiotics showed no clear difference in reconsultation rate: delayed (all strategies) versus immediate… compared with immediate antibiotics (moderate certainty).

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  OR 1.04 [0.66, 1.63]
  4 studies · 972 participants
  Moderate

Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 1302 participants
  Low

Summary of findings table ‐ Delayed antibiotics vs no antibiotics

Summary of findings table ‐ Delayed antibiotics probably leads to higher antibiotic use: delayed (all strategies) versus no antibiotics compared with no antibiotics (moderate certainty).

• Immediate versus delayed versus no antibiotics for respiratory infections 2023 · Cochrane Headline outcomes only
  OR 2.52 [1.69, 3.75]
  5 studies · 1529 participants
  Moderate

Antibiotics vs placebo

Antibiotics showed no clear difference in pain ‐ pain at 24 hours compared with placebo (high certainty).

• Antibiotics for acute otitis media in children 2023 · Cochrane Headline outcomes only
  RR 0.89 [0.78, 1.01]
  5 studies · 1394 participants
  High

Antibiotics vs placebo

Antibiotics leads to lower pain ‐ pain at 2 to 3 days compared with placebo (high certainty).

• Antibiotics for acute otitis media in children 2023 · Cochrane Headline outcomes only
  RR 0.71 [0.58, 0.88]
  7 studies · 2320 participants
  High

Antibiotics vs placebo

Antibiotics showed no clear difference in pain ‐ pain at 4 to 7 days compared with placebo (high certainty).

• Antibiotics for acute otitis media in children 2023 · Cochrane Headline outcomes only
  RR 0.76 [0.5, 1.14]
  7 studies · 1264 participants
  High

Antibiotics vs placebo

Antibiotics probably leads to lower pain ‐ pain at 10 to 12 days compared with placebo (moderate certainty).

• Antibiotics for acute otitis media in children 2023 · Cochrane Headline outcomes only
  RR 0.33 [0.17, 0.66]
  1 study · 278 participants
  Moderate

Antibiotics vs placebo

Antibiotics leads to higher vomiting, diarrhoea or rash compared with placebo (high certainty).

• Antibiotics for acute otitis media in children 2023 · Cochrane Headline outcomes only
  RR 1.38 [1.16, 1.63]
  8 studies · 2107 participants
  High