Cochrane · systematic review · CD004417

Immediate versus delayed versus no antibiotics for respiratory infections

Spurling, GKP, Dooley, L, Clark, J, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library

Acute Respiratory Infections2 versionsAMSTAR 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
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 1 · 8.3%Moderate 11 · 91.7%High 0 · 0%

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

Show all 2 versions

Summary of findings table ‐ Delayed antibiotics compared to immediate antibiotics for respiratory infections

Population: respiratory infections
6 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical outcomes
Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics
no estimate extracted11 studies · 2748 participantsModerate
Downgraded: risk of bias
Duration of clinical outcomes (pain, malaise, fever)
Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics
no estimate extracted3 studies · 1077 participantsModerate
Downgraded: risk of bias
Antibiotic use: delayed (all strategies) versus immediate antibiotics
Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics
OR 0.03 [0.01, 0.07]8 studies · 2257 participantsModerate
Downgraded: risk of bias
Patient satisfaction: delayed (all strategies) versus immediate antibiotics
Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics
OR 0.77 [0.45, 1.29]7 studies · 1927 participantsModerate
Downgraded: risk of bias
Reconsultation rate: delayed (all strategies) versus immediate antibiotics
Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics
OR 1.04 [0.66, 1.63]4 studies · 972 participantsModerate
Downgraded: risk of bias
Adverse effects of antibiotics
Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics
no estimate extracted5 studies · 1302 participantsLow
Downgraded: risk of bias, inconsistency

Summary of findings table ‐ Delayed antibiotics compared to no antibiotics for respiratory infections

Population: respiratory infections
6 questions
OutcomeEffectEvidenceStatus / GRADE
Clinical outcomes: pain, malaise, fever
Summary of findings table ‐ Delayed antibiotics vs no antibiotics
no estimate extracted5 studies · 1685 participantsModerate
Downgraded: risk of bias
Duration of clinical outcomes (pain, malaise, fever)
Summary of findings table ‐ Delayed antibiotics vs no antibiotics
no estimate extracted2 studies · 585 participantsModerate
Downgraded: risk of bias
Antibiotic use: delayed (all strategies) versus no antibiotics
Summary of findings table ‐ Delayed antibiotics vs no antibiotics
OR 2.52 [1.69, 3.75]5 studies · 1529 participantsModerate
Downgraded: risk of bias
Patient satisfaction: delayed (prescription collection) versus no antibiotics
Summary of findings table ‐ Delayed antibiotics vs no antibiotics
OR 1.45 [1.08, 1.96]5 studies · 1523 participantsModerate
Downgraded: risk of bias
Reconsultation rate: delayed (all strategies) versus no antibiotics
Summary of findings table ‐ Delayed antibiotics vs no antibiotics
OR 0.83 [0.46, 1.52]2 studies · 584 participantsModerate
Downgraded: risk of bias
Adverse effects of antibiotics (diarrhoea, vomiting, rash): delayed versus no antibiotics
Summary of findings table ‐ Delayed antibiotics vs no antibiotics
no estimate extracted2 studies · 674 participantsModerate
Downgraded: risk of bias