What do systematic reviews say?

Antibiotics vs placebo overall

Antibiotics showed no clear difference in adverse events ‐ diarrhoea compared with placebo overall (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  OR 1.68 [0.92, 3.07]
  5 studies · 1099 participants
  Moderate

Antibiotics vs placebo

Antibiotics showed no clear difference in serious adverse events WMD of compared with placebo (moderate certainty).

• Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD) 2018 · Cochrane Headline outcomes only
  OR 0.88 [0.74, 1.05]
  9 studies · 2978 participants
  Moderate

Summary of findings: Inhaled antibiotics vs IV antibiotics

• Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 18 participants
  Very low

Antibiotics vs placebo overall

Antibiotics showed no clear difference in adverse events ‐ overall (any adverse events not specified) compared with placebo overall (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  OR 1.2 [0.89, 1.63]
  6 studies · 1544 participants
  Moderate

Summary of findings: Inhaled antibiotics plus IV antibiotics vs IV antibiotics

It is very uncertain whether summary of findings: Inhaled antibiotics plus IV antibiotics changes adverse events moderate adverse events experienced during and after… compared with IV antibiotics only (very low certainty).

• Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 28 participants
  Very low