What do systematic reviews say?

Oral plus nebulised antibiotics vs oral antibiotics plus nebulised placebo

Oral plus nebulised antibiotics showed no clear difference in adverse effects of treatment compared with oral antibiotics plus nebulised placebo (low certainty).

• Interventions for the eradication of meticillin‐resistant Staphylococcus aureus (MRSA) in people with cystic fibrosis 2022 · Cochrane Headline outcomes only
  OR 3 [0.11, 79.91]
  1 study · 29 participants
  Low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes adverse effects compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  1st to 7th day
  RR 1.46 [0.81, 2.64]
  8 studies · 1277 participants
  Very low

Single preoperative dose of systemic antibiotics (clindamycin 600 mg), total chemo-mechanical debridement and root filling vs Matched placebo, total chemo-mechanical debridement and root filling

• Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults 2024 · Cochrane All outcomes

  7 days
  No adverse effects reported in the placebo group; 1 participant reported dizziness in the intervention group. 72 participants (1 study).
  1 study · 72 participants
  Low

Summary of findings: intranasal steroids plus oral antibiotic vs control plus antibiotic

• Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children 2011 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 59 participants
  GRADE not reported

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

• Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults 2024 · Cochrane All outcomes

  3 days
  1 participant reported diarrhoea (placebo group); 1 participant reported fatigue and reduced energy postoperatively (antibiotic group). 61 participants (2 studies).
  2 studies · 61 participants
  Very low

Antibiotics at time of replacement vs no antibiotics at time of replacement

The review found no eligible studies for this question.

• Policies for replacing long‐term indwelling urinary catheters in adults 2016 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Summary of findings: oral steroids plus antibiotic showed no clear difference in adverse effects [2 weeks to 6 months] compared with control plus antibiotic (low certainty).

• Oral or topical nasal steroids for hearing loss associated with otitis media with effusion in children 2011 · Cochrane Headline outcomes only
  RR 1.5 [0.81, 2.78]
  2 studies · 255 participants
  Low

Combined HBO and perioperative antibiotics prior to dental implant therapy vs antibiotics alone

• Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy 2019 · Cochrane All outcomes

  1 year
  This comparison was only made in 1 study which reported no serious adverse events associated with HBO therapy. Quality of life measures (oral status, functioning, satisfaction) showed emotional functioning and pain…
  1 study · 26 participants
  Very low

Prophylactic antibiotics vs placebo or no treatment

The review found no eligible studies for this question.

• Prophylactic antibiotics for preventing infection after continence surgery in women with stress urinary incontinence 2022 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Inhaled tobramycin (TNS) (28 days) vs TNS (56 days)

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 77 participants
  Very low

Oral ciprofloxacin and inhaled colistin vs no treatment

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 26 participants
  Very low

Intravenous ceftazidime with tobramycin vs ciprofloxacin

Intravenous ceftazidime with tobramycin probably leads to lower adverse effects of antibiotics: compared with oral ciprofloxacin (moderate certainty).

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  RR 0.97
  1 study · 285 participants
  Moderate

Oral ciprofloxacin and inhaled colistin vs inhaled tobramycin

It is very uncertain whether oral ciprofloxacin and inhaled colistin changes adverse effects of antibiotics: severe cough compared with inhaled tobramycin (TNS) (very low certainty).

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  OR 0.32 [0.01, 8.24]
  1 study · 58 participants
  Very low

Oral vs topical antibiotics

• Antibiotics for trachoma 2019 · Cochrane Headline outcomes only
  no estimate extracted
  8 studies · 1583 participants
  Low

Inhaled tobramycin (TNS) vs placebo

It is very uncertain whether inhaled tobramycin (TNS) changes adverse effects of antibiotics: participants experiencing cough compared with placebo (very low certainty).

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  OR 0.76 [0.1, 5.77]
  2 studies · 72 participants
  Very low

Oral ciprofloxacin and inhaled colistin vs inhaled tobramycin (TNS) plus oral ciprofloxacin

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 223 participants
  Moderate

Intervention not reported

It is very uncertain whether the intervention changes number of participants who experienced any adverse effects related… (very low certainty).

• Antibiotics for infection prevention after excision of the cervical transformation zone 2017 · Cochrane Headline outcomes only
  RR 1.69 [0.85, 3.34]
  2 studies · 638 participants
  Very low

Inhaled tobramycin (TNS) plus oral azithromycin vs TNS plus oral placebo

Inhaled tobramycin (TNS) plus oral azithromycin showed no clear difference in adverse effects of antibiotics: number of participants experiencing… compared with TNS plus oral placebo (moderate certainty).

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  RR 1.05 [0.96, 1.14]
  1 study · 221 participants
  Moderate

14 days inhaled AZLI plus 14 days placebo vs 28 days inhaled AZLI

The review found no eligible studies for this question.

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Ciprofloxacin vs placebo added to cycled and culture‐based inhaled tobramycin (TNS) therapy

Ciprofloxacin showed no clear difference in adverse effects of antibiotics: proportion of participants with one… compared with placebo added to cycled and culture‐based inhaled tobramycin (TNS)… (moderate certainty).

• Antibiotic strategies for eradicating Pseudomonas aeruginosa in people with cystic fibrosis 2023 · Cochrane Headline outcomes only
  OR 1.54 [0.93, 2.57]
  1 study · 304 participants
  Moderate