What do systematic reviews say?

Amoxicillin + clavulanate + SRP vs Tetracycline + SRP

Amoxicillin + clavulanate + SRP showed no clear difference in adverse events compared with tetracycline + SRP; GRADE not reported.

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
  The only included trial (Abu Fanas 1991) reported there were no adverse events.
  1 study · 8 participants
  GRADE not reported

Amoxicillin + clavulanate + SRP vs SRP

It is very uncertain whether amoxicillin + clavulanate + SRP changes adverse events compared with SRP (very low certainty).

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Long-term (≥ 1 year)
  Included study reported diarrhoea in 2 participants from both groups.
  1 study · 21 participants
  Very low

Amoxicillin + metronidazole + SRP vs Clarithromycin + SRP

Amoxicillin + metronidazole + SRP showed no clear difference in adverse events compared with clarithromycin + SRP; GRADE not reported.

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
  Two patients were reported to have vomiting and unbearable stomach pain in the AMOX + MTZ + SRP group (Araujo 2019).
  1 study
  GRADE not reported

Amoxicillin + metronidazole + SRP vs SRP

It is very uncertain whether amoxicillin + metronidazole + SRP changes adverse events compared with SRP (very low certainty).

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Long-term (≥ 1 year)
  Most common adverse events were mild gastrointestinal disturbances, nausea and vomiting, metallic taste, and diarrhoea in the intervention group. Control group reported adverse events like hypothermia, mild…
  2 studies · 389 participants
  Very low

Comparison 2: 7 days oral amoxicillin vs 7 days injectable benzylpenicillin + injectable gentamicin

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 1406 participants
  Moderate

Prophylactic systemic antibiotics (amoxicillin) vs placebo or no antibiotic

Prophylactic systemic antibiotics (amoxicillin) showed no clear difference in adverse events compared with no antibiotics or placebo; GRADE not reported.

• Interventions for replacing missing teeth: antibiotics at dental implant placement to prevent complications 2013 · Cochrane All outcomes

  3 to 5 months
  RR 1.0 [0.06, 15.85]
  6 studies · 1162 participants
  GRADE not reported

Comparison 2: 7 days oral amoxicillin + injectable gentamicin vs 7 days injectable benzylpenicillin + injectable gentamicin

Comparison 2: 7 days oral amoxicillin + injectable gentamicin showed no clear difference in adverse events compared with 7 days injectable benzylpenicillin + injectable gentamicin (moderate certainty).

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  RR 1.35 [0.72, 2.53]
  3 studies · 2001 participants
  Moderate

Comparison 2: 2 days oral amoxicillin + injectable gentamicin followed by 5 days oral amoxicillin vs 7 days injectable benzylpenicillin + injectable gentamicin

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 893 participants
  High

Comparison 2: 2 days injectable benzylpenicillin + injectable gentamicin followed by 5 days oral amoxicillin vs 7 days injectable benzylpenicillin + injectable gentamicin

Comparison 2: 2 days injectable benzylpenicillin + injectable… showed no clear difference in adverse events compared with 7 days injectable benzylpenicillin + injectable gentamicin (moderate certainty).

• Community‐based antibiotic delivery for possible serious bacterial infections in neonates in low‐ and middle‐income… 2019 · Cochrane Headline outcomes only
  RR 1.39 [0.67, 2.87]
  3 studies · 2036 participants
  Moderate

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes adverse events due to periodontal therapy compared with supragingival scaling (plus placebo) (very low certainty).

• Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes

  12 months
  Peto OR 0.14 [0.00, 6.90]
  1 study · 165 participants
  Very low

Metronidazole + SRP vs Amoxicillin + metronidazole + SRP

Metronidazole + SRP showed no clear difference in adverse events compared with amoxicillin + metronidazole + SRP; GRADE not reported.

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
  All three included trials (Matarazzo 2008; Silva 2011; Xajigeorgiou 2006) reported adverse events in both MTZ + SRP and AMOX + MTZ + SRP groups (nausea, vomiting, diarrhoea, headache, metallic taste, irritability, mild…
  3 studies · 84 participants
  GRADE not reported

Doxycycline + SRP vs Amoxicillin + metronidazole + SRP

Doxycycline + SRP showed no clear difference in adverse events compared with amoxicillin + metronidazole + SRP; GRADE not reported.

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
  One trial (Akincibay 2008) did not report this outcome; Xajigeorgiou 2006 reported mild gastrointestinal discomfort in 2 subjects from the AMOX + MTZ + SRP group.
  1 study
  GRADE not reported

Fluoroquinolones vs amoxicillin

• Head‐to‐head trials of antibiotics for bronchiectasis 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 83 participants
  Low

Moxifloxacin vs amoxicillin‐clavulanate

It is very uncertain whether moxifloxacin changes serious adverse events (SAE) compared with amoxicillin‐clavulanate (very low certainty).

• Interventions for necrotizing soft tissue infections in adults 2018 · Cochrane Headline outcomes only
  RR 0.63 [0.3, 1.31]
  1 study · 54 participants
  Very low

Azithromycin vs amoxicillin

It is very uncertain whether azithromycin changes adverse events (ITT analysis) compared with amoxicillin (very low certainty).

• Different antibiotic treatments for group A streptococcal pharyngitis 2023 · Cochrane Headline outcomes only
  OR 2.67 [1.78, 3.99]
  1 study · 673 participants
  Very low

Intramuscular ceftriaxone vs oral amoxicillin plus oral probenecid

It is very uncertain whether intramuscular ceftriaxone changes adverse events including treatment‐related adverse events compared with oral amoxicillin plus oral probenecid (very low certainty).

• Antibiotics for treating gonorrhoea in pregnancy 2018 · Cochrane Headline outcomes only
  RR 0.33 [0.01, 8.07]
  1 study · 168 participants
  Very low