What do systematic reviews say?

Antibiotics vs other antibiotics

• Antibiotics for acute maxillary sinusitis in adults 2014 · Cochrane Headline outcomes only
  no estimate extracted
  10 studies · 54 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

Antibiotics vs placebo

Antibiotics leads to lower abnormal tympanometry ‐ 2 to 4 weeks compared with placebo (high certainty).

• Antibiotics for acute otitis media in children 2023 · Cochrane Headline outcomes only
  RR 0.83 [0.72, 0.96]
  7 studies · 2138 participants
  High

Antibiotics vs placebo

Antibiotics showed no clear difference in abnormal tympanometry ‐ 3 months compared with placebo (high certainty).

• Antibiotics for acute otitis media in children 2023 · Cochrane Headline outcomes only
  RR 0.94 [0.66, 1.34]
  3 studies · 809 participants
  High

Antibiotics vs control

Antibiotics probably leads to lower sore throat: day 3 compared with control (moderate certainty).

• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  RR 0.7 [0.6, 0.8]
  16 studies · 3730 participants
  Moderate
• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  RR 0.5 [0.34, 0.75]
  14 studies · 3083 participants
  Moderate

Antibiotics vs control

Antibiotics showed no clear difference in fever: day 3 compared with control (high certainty).

• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  RR 0.75 [0.53, 1.07]
  8 studies · 1443 participants
  High

Antibiotics vs control

Antibiotics leads to lower headache: day 3 compared with control (high certainty).

• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  RR 0.49 [0.34, 0.7]
  4 studies · 1020 participants
  High

Antibiotics vs control

Antibiotics probably leads to lower rheumatic fever (within 2 months, clinical diagnosis) compared with control (moderate certainty).

• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  Peto OR 0.32 [0.18, 0.58]
  17 studies · 12132 participants
  Moderate

Antibiotics vs control

Antibiotics showed no clear difference in glomerulonephritis (within 1 month, clinical diagnosis) compared with control (low certainty).

• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  Peto OR 0.07 [0, 1.32]
  10 studies · 5147 participants
  Low

Antibiotics vs control

Antibiotics leads to lower quinsy (within 2 months, clinical diagnosis) compared with control (high certainty).

• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  Peto OR 0.16 [0.07, 0.35]
  7 studies · 2367 participants
  High

Antibiotics vs control

Antibiotics leads to lower otitis media (within 14 days, clinical diagnosis) compared with control (high certainty).

• Antibiotics for treatment of sore throat in children and adults 2021 · Cochrane Headline outcomes only
  Peto OR 0.21 [0.11, 0.4]
  10 studies · 3646 participants
  High

Antibiotics vs placebo

Antibiotics leads to higher cure in adults with clinically diagnosed acute rhinosinusitis compared with placebo (high certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  OR 1.25 [1.02, 1.54]
  8 studies · 1687 participants
  High

Antibiotics vs placebo

Antibiotics probably leads to higher cure in adults with acute rhinosinusitis confirmed by radiography1 compared with placebo (moderate certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  OR 1.57 [1.03, 2.39]
  3 studies · 394 participants
  Moderate

Antibiotics vs placebo

Antibiotics probably leads to higher cure in adults with acute rhinosinusitis confirmed by computed… compared with placebo (moderate certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  OR 4.89 [1.75, 13.72]
  1 study · 127 participants
  Moderate

Antibiotics vs placebo

Antibiotics leads to higher severity or duration of different clinical symptoms: resolution of… compared with placebo (high certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  OR 1.58 [1.13, 2.22]
  3 studies · 660 participants
  High

Antibiotics vs placebo

Antibiotics leads to higher side effects: total compared with placebo (high certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  OR 2.21 [1.74, 2.82]
  10 studies · 1816 participants
  High