Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

271 questions · 277 findings · 30 reviews · Headline outcomes only

No studies found 31 · 11.2%GRADE not reported 10 · 3.6%Very low 93 · 33.6%Low 64 · 23.1%Moderate 65 · 23.5%High 14 · 5.1%

Topical plus systemic prophylaxis vs placebo or no treatment

Allergic adverse events · adults receiving mechanical ventilation for at least 48 hours

Topical plus systemic prophylaxis showed no clear difference in allergic adverse events compared with placebo or no treatment (low certainty).

1 finding from 1 review

Antibiotics vs placebo or no intervention

All‐cause mortality · farmworkers, soldiers, and people in endemic areas

Summary of findings table ‐ Antibiotics showed no clear difference in all‐cause mortality compared with placebo or no intervention (low certainty).

1 finding from 1 review

Antibiotics vs placebo or no intervention

Laboratory‐confirmed leptospirosis · farmworkers, soldiers, and people in endemic areas

It is very uncertain whether summary of findings table ‐ Antibiotics changes laboratory‐confirmed leptospirosis compared with placebo or no intervention (very low certainty).

1 finding from 1 review

Antibiotics vs placebo or no intervention

Clinical diagnosis of infection regardless of laboratory confirmed · farmworkers, soldiers, and people in endemic areas

Summary of findings table ‐ Antibiotics showed no clear difference in clinical diagnosis of infection regardless of laboratory confirmed compared with placebo or no intervention (low certainty).

1 finding from 1 review

Antibiotics vs placebo or no intervention

Clinical diagnosis confirmed by laboratory diagnosis · farmworkers, soldiers, and people in endemic areas

Summary of findings table ‐ Antibiotics showed no clear difference in clinical diagnosis confirmed by laboratory diagnosis compared with placebo or no intervention (low certainty).

1 finding from 1 review

Antibiotics vs placebo or no intervention

Non‐serious adverse events · farmworkers, soldiers, and people in endemic areas

It is very uncertain whether summary of findings table ‐ Antibiotics changes non‐serious adverse events compared with placebo or no intervention (very low certainty).

1 finding from 1 review

Summary of findings ‐ initiation of penicillin prophylaxis vs placebo

Incidence of S pneumoniae infection Isolated bacterial infection · children with SCD

Summary of findings ‐ initiation of penicillin prophylaxis may leads to lower incidence of S pneumoniae infection Isolated bacterial infection compared with placebo (low certainty).

1 finding from 1 review

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