What do systematic reviews say?

Antibiotics vs placebo

Antibiotics leads to higher severity or duration of different clinical symptoms: resolution of… compared with placebo (high certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  OR 1.58 [1.13, 2.22]
  3 studies · 660 participants
  High

Antibiotics vs placebo

Antibiotics leads to higher side effects: total compared with placebo (high certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  OR 2.21 [1.74, 2.82]
  10 studies · 1816 participants
  High

Antibiotics vs placebo

Antibiotics leads to higher side effects: diarrhoea compared with placebo (high certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  Peto OR 2 [1.41, 2.85]
  7 studies · 1210 participants
  High

Antibiotics vs placebo

Antibiotics leads to lower clinical failure compared with placebo (high certainty).

• Antibiotics for acute rhinosinusitis in adults 2018 · Cochrane Headline outcomes only
  Peto OR 0.48 [0.36, 0.63]
  12 studies · 2603 participants
  High

Antibiotics vs placebo

Antibiotics may leads to lower treatment failure within 4 weeks ‐ current drugs only compared with placebo (low certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  RR 0.72 [0.56, 0.94]
  7 studies · 1191 participants
  Low

Antibiotics vs placebo overall

Antibiotics showed no clear difference in adverse events ‐ overall (any adverse events not specified) compared with placebo overall (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  OR 1.2 [0.89, 1.63]
  6 studies · 1544 participants
  Moderate

Antibiotics vs placebo

Antibiotics showed no clear difference in all‐cause mortality compared with placebo (low certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  OR 1.27 [0.49, 3.3]
  1 study · 301 participants
  Low

Antibiotics vs placebo

Antibiotics showed no clear difference in treatment failure within 4 weeks ‐ current drugs only ‐ inpatient compared with placebo (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  RR 0.65 [0.38, 1.12]
  4 studies · 576 participants
  Moderate

Antibiotics vs placebo

Antibiotics probably leads to lower treatment failure within 4 weeks ‐ drugs not currently used ‐ ICU compared with placebo (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  RR 0.19 [0.08, 0.45]
  1 study · 93 participants
  Moderate

Antibiotics vs placebo

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 300 participants
  High

Antibiotics vs placebo

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 94 participants
  Moderate

Antibiotics vs placebo

Antibiotics showed no clear difference in all‐cause mortality ‐ inpatients compared with placebo (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  OR 2.48 [0.94, 6.55]
  2 studies · 214 participants
  Moderate

Antibiotics vs placebo

Antibiotics probably leads to lower all‐cause mortality ‐ ICU patients compared with placebo (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  OR 0.21 [0.06, 0.72]
  1 study · 93 participants
  Moderate

Antibiotics vs placebo overall

Antibiotics showed no clear difference in adverse events ‐ diarrhoea compared with placebo overall (moderate certainty).

• Antibiotics for exacerbations of chronic obstructive pulmonary disease 2018 · Cochrane Headline outcomes only
  OR 1.68 [0.92, 3.07]
  5 studies · 1099 participants
  Moderate

Antibiotics vs no treatment

The review found no eligible studies for this question.

• Antibiotics for asymptomatic bacteriuria in kidney transplant recipients 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Antibiotics vs no treatment

Antibiotics showed no clear difference in symptomatic UTI compared with no treatment (low certainty).

• Antibiotics for asymptomatic bacteriuria in kidney transplant recipients 2018 · Cochrane Headline outcomes only
  RR 0.86 [0.51, 1.45]
  2 studies · 200 participants
  Low

Antibiotics vs no treatment

Antibiotics showed no clear difference in antimicrobial resistance compared with no treatment (low certainty).

• Antibiotics for asymptomatic bacteriuria in kidney transplant recipients 2018 · Cochrane Headline outcomes only
  RR 1.21 [0.6, 2.41]
  1 study · 112 participants
  Low

Antibiotics vs no treatment

Antibiotics showed no clear difference in all‐cause mortality compared with no treatment (low certainty).

• Antibiotics for asymptomatic bacteriuria in kidney transplant recipients 2018 · Cochrane Headline outcomes only
  RR 2.23 [0.21, 23.86]
  1 study · 112 participants
  Low

Antibiotics vs no treatment

Antibiotics showed no clear difference in graft loss compared with no treatment (low certainty).

• Antibiotics for asymptomatic bacteriuria in kidney transplant recipients 2018 · Cochrane Headline outcomes only
  RR 1.11 [0.07, 17.36]
  1 study · 112 participants
  Low

Antibiotics vs no treatment

Antibiotics showed no clear difference in acute graft rejection compared with no treatment (low certainty).

• Antibiotics for asymptomatic bacteriuria in kidney transplant recipients 2018 · Cochrane Headline outcomes only
  RR 0.93 [0.44, 1.97]
  1 study · 112 participants
  Low