Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,296 questions · 1,330 findings · 157 reviews · Headline outcomes only

No studies found 297 · 22.3%GRADE not reported 88 · 6.6%Very low 327 · 24.6%Low 317 · 23.8%Moderate 239 · 18%High 62 · 4.7%

Azithromycin vs placebo or usual care

Serious adverse events during the study period · people with moderate to severe disease (WHO scale 4–9); all studies contributing results to the summary of findings table included people…

Azithromycin showed no clear difference in serious adverse events during the study period compared with placebo or standard of care alone (moderate certainty).

1 finding from 1 review

Azithromycin vs placebo or usual care

Adverse events during treatment period · people with moderate to severe disease (WHO scale 4–9); all studies contributing results to the summary of findings table included people…

Azithromycin showed no clear difference in any adverse events during the study period compared with placebo or standard of care alone (low certainty).

1 finding from 1 review

Azithromycin vs placebo or usual care

Arrhythmias · people with moderate to severe disease (WHO scale 4–9); all studies contributing results to the summary of findings table included people…

Azithromycin showed no clear difference in cardiac arrhythmias during the study period compared with placebo or standard of care alone (moderate certainty).

1 finding from 1 review

Azithromycin vs placebo or usual care

All‐cause mortality at day 28 · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

Azithromycin showed no clear difference in all‐cause mortality at day 28 compared with placebo or standard of care alone (low certainty).

1 finding from 1 review

Azithromycin vs placebo or usual care

Admission to hospital or death within 28 days · all trials contributing results to the summary of findings table included people with mild disease (WHO scale 1 to 3)§

Azithromycin showed no clear difference in admission to hospital or death within 28 days compared with placebo or standard of care alone (low certainty).

1 finding from 1 review

Intervention not reported

Health‐related quality of life · CSOM, recurrence of CSOM or suppuration following mastoidectomy or tympanoplasty

The review found no eligible studies for this question.

1 finding from 1 review

Intervention not reported

Ear pain (otalgia) or discomfort or local irritation · CSOM, recurrence of CSOM or suppuration following mastoidectomy or tympanoplasty

The review found no eligible studies for this question.

1 finding from 1 review

Intervention not reported

Hearing · CSOM, recurrence of CSOM or suppuration following mastoidectomy or tympanoplasty

The review found no eligible studies for this question.

1 finding from 1 review

Intervention not reported

Serious complications · CSOM, recurrence of CSOM or suppuration following mastoidectomy or tympanoplasty

The review found no eligible studies for this question.

1 finding from 1 review

Intervention not reported

Suspected ototoxicity · CSOM, recurrence of CSOM or suppuration following mastoidectomy or tympanoplasty
1 finding from 1 review

Quinolone vs aminoglycosides

Resolution of ear discharge ‐ measured at 1 to 2 weeks · people (of any age) with CSOM

It is very uncertain whether quinolones changes resolution of ear discharge ‐ measured at 1 to 2 weeks compared with aminoglycosides (very low certainty).

1 finding from 1 review

Intervention not reported

Resolution of ear discharge‐ measured at 1 to 2 weeks · CSOM, recurrence of CSOM or suppuration following mastoidectomy or tympanoplasty

The intervention may leads to higher resolution of ear discharge‐ measured at 1 to 2 weeks (low certainty).

1 finding from 1 review

Intervention not reported

Resolution of ear discharge ‐ measured after 4 weeks · CSOM, recurrence of CSOM or suppuration following mastoidectomy or tympanoplasty

The review found no eligible studies for this question.

1 finding from 1 review

Antibiotics vs placebo or no treatment

Recurrence of symptomatic UTI in children · children with previous UTI and most do not have a renal tract abnormality such as VUR

Antibiotic treatment showed no clear difference in recurrence of symptomatic UTI in children compared with placebo or no treatment (low certainty).

1 finding from 1 review