Cochrane · systematic review · CD000022
Topical antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving mechanical ventilation
Minozzi, S, Pifferi, S, Brazzi, L, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library
Acute Respiratory InfectionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
14
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 2 · 14.3%Low 8 · 57.1%Moderate 3 · 21.4%High 1 · 7.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Topical plus systemic prophylaxis versus placebo or no treatment in adults receiving mechanical ventilation for at least 48 hours
Population: adults receiving mechanical ventilation for at least 48 hours
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall mortality Topical plus systemic prophylaxis vs placebo or no treatment | RR 0.84 [0.73, 0.96] | 18 studies · 5290 participants | High |
Respiratory tract infections Topical plus systemic prophylaxis vs placebo or no treatment | RR 0.43 [0.35, 0.53] | 17 studies · 2951 participants | Moderate Downgraded: publication bias |
Dropouts due to adverse events Topical plus systemic prophylaxis vs placebo or no treatment | RR 1.06 [0.3, 3.76] | 4 studies · 1287 participants | Low Downgraded: imprecision |
Gastrointestinal adverse events Topical plus systemic prophylaxis vs placebo or no treatment | RR 1.08 [0.57, 2.04] | 6 studies · 2637 participants | Low Downgraded: imprecision |
Allergic adverse events Topical plus systemic prophylaxis vs placebo or no treatment | RR 1.49 [0.09, 25.33] | 6 studies · 2981 participants | Low Downgraded: imprecision |
Topical prophylaxis versus no topical prophylaxis in adults receiving mechanical ventilation for at least 48 hours
Population: adults receiving mechanical ventilation for at least 48 hours
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall mortality Topical prophylaxis vs no topical prophylaxis | RR 0.96 [0.87, 1.05] | 22 studies · 4213 participants | Moderate Downgraded: risk of bias, imprecision |
Overall mortality ‐ topical plus systemic prophylaxis versus systemic prophylaxis alone Topical prophylaxis vs no topical prophylaxis | RR 0.92 [0.72, 1.18] | 7 studies · 939 participants | Low Downgraded: risk of bias, imprecision |
Overall mortality ‐ topical prophylaxis versus placebo or no treatment Topical prophylaxis vs no topical prophylaxis | RR 0.97 [0.87, 1.07] | 15 studies · 3274 participants | Moderate Downgraded: risk of bias, imprecision |
Respiratory tract infections Topical prophylaxis vs no topical prophylaxis | RR 0.57 [0.44, 0.74] | 19 studies · 2698 participants | Low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Respiratory tract infections ‐ topical plus systemic prophylaxis versus systemic prophylaxis alone Topical prophylaxis vs no topical prophylaxis | RR 0.82 [0.58, 1.16] | 6 studies · 850 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Respiratory tract infections ‐ topical prophylaxis versus no treatment or placebo Topical prophylaxis vs no topical prophylaxis | RR 0.5 [0.36, 0.69] | 13 studies · 1848 participants | Low Downgraded: risk of bias, imprecision, publication bias |
Dropouts due to adverse events Topical prophylaxis vs no topical prophylaxis | RR 2.2 [0.57, 8.54] | 7 studies · 1323 participants | Very low Downgraded: risk of bias, imprecision |
Gastrointestinal adverse events Topical prophylaxis vs no topical prophylaxis | RR 2.78 [0.26, 29.5] | 3 studies · 1859 participants | Low Downgraded: imprecision |
Allergic adverse events Topical prophylaxis vs no topical prophylaxis | RR 2.64 [0.34, 20.69] | 5 studies · 2357 participants | Very low Downgraded: risk of bias, imprecision |