Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

4,721 questions · 19,640 findings · 2,039 reviews · Headline outcomes only

No studies found 3,754 · 19.1%GRADE not reported 1,273 · 6.5%Very low 4,859 · 24.7%Low 5,568 · 28.4%Moderate 3,240 · 16.5%High 946 · 4.8%

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Summary of findings ‐ withdrawal of penicillin prophylaxis vs continuation

Incidence of S pneumoniae Confirmed bacterial infection · children with SCD who have been receiving prophylactic penicillin for at least two years

Summary of findings ‐ withdrawal of penicillin prophylaxis showed no clear difference in incidence of S pneumoniae Confirmed bacterial infection compared with continuation (low certainty).

1 finding from 1 review

Summary of findings ‐ withdrawal of penicillin prophylaxis vs continuation

Nausea and vomiting · children with SCD who have been receiving prophylactic penicillin for at least two years

Summary of findings ‐ withdrawal of penicillin prophylaxis showed no clear difference in adverse effects: incidences of nausea and vomiting compared with continuation (low certainty).

1 finding from 1 review

Antibiotics vs placebo or no intervention

Cardiovascular mortality · patients with coronary heart disease

Antibiotics leads to higher cardiovascular mortality at 24±6 months compared with placebo or no intervention (high certainty).

2 findings from 1 review

Antibiotics vs placebo or no intervention

Myocardial infarction · patients with coronary heart disease

Antibiotics showed no clear difference in myocardial infarction at 24±6 months compared with placebo or no intervention (moderate certainty).

2 findings from 1 review

Antibiotics vs placebo or no intervention

Stroke · patients with coronary heart disease

Antibiotics showed no clear difference in stroke at 24±6 months compared with placebo or no intervention (high certainty).

2 findings from 1 review

Antibiotics vs placebo or no intervention

Sudden cardiac death · patients with coronary heart disease

Antibiotics probably leads to higher sudden cardiac death at 24±6 months compared with placebo or no intervention (moderate certainty).

2 findings from 1 review