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
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
Current version onlySummary of findings table ‐ Delayed antibiotics compared to immediate antibiotics for respiratory infections
Population: respiratory infections
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical outcomes Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics | no estimate extracted | 11 studies · 2748 participants | Moderate Downgraded: risk of bias |
Duration of clinical outcomes (pain, malaise, fever) Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics | no estimate extracted | 3 studies · 1077 participants | Moderate 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 participants | Moderate 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 participants | Moderate 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 participants | Moderate Downgraded: risk of bias |
Adverse effects of antibiotics Summary of findings table ‐ Delayed antibiotics vs immediate antibiotics | no estimate extracted | 5 studies · 1302 participants | Low Downgraded: risk of bias, inconsistency |
Summary of findings table ‐ Delayed antibiotics compared to no antibiotics for respiratory infections
Population: respiratory infections
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical outcomes: pain, malaise, fever Summary of findings table ‐ Delayed antibiotics vs no antibiotics | no estimate extracted | 5 studies · 1685 participants | Moderate Downgraded: risk of bias |
Duration of clinical outcomes (pain, malaise, fever) Summary of findings table ‐ Delayed antibiotics vs no antibiotics | no estimate extracted | 2 studies · 585 participants | Moderate 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 participants | Moderate 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 participants | Moderate 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 participants | Moderate 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 extracted | 2 studies · 674 participants | Moderate Downgraded: risk of bias |
Delayed antibiotics compared to immediate antibiotics for respiratory infections
Population: respiratory infections
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical outcomes Delayed antibiotics vs immediate antibiotics | no estimate extracted | 10 studies · 2419 participants | Moderate Downgraded: risk of bias |
Antibiotic use: delayed versus immediate antibiotics Delayed antibiotics vs immediate antibiotics | OR 0.04 [0.03, 0.05] | 7 studies · 1963 participants | Moderate Downgraded: risk of bias |
Patient satisfaction: delayed versus immediate antibiotics Delayed antibiotics vs immediate antibiotics | OR 0.65 [0.39, 1.1] | 6 studies · 1633 participants | Moderate Downgraded: risk of bias |
Reconsultation rate: delayed versus immediate antibiotics Delayed antibiotics vs immediate antibiotics | OR 1.04 [0.55, 1.98] | 2 studies · 379 participants | Moderate Downgraded: risk of bias |
Adverse effects of antibiotics (Adverse effects) Delayed antibiotics vs immediate antibiotics | no estimate extracted | 5 studies · 1303 participants | Low Downgraded: risk of bias, inconsistency |
Delayed antibiotics compared to No antibiotics for respiratory infections
Population: respiratory infections
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical outcomes (clinical outcomes) Delayed antibiotics vs No antibiotics | no estimate extracted | 4 studies · 955 participants | Moderate Downgraded: risk of bias |
Antibiotic use: delayed versus no antibiotics Delayed antibiotics vs No antibiotics | OR 2.55 [1.59, 4.08] | 4 studies · 1241 participants | Moderate Downgraded: risk of bias |
Patient satisfaction: delayed versus no antibiotics Delayed antibiotics vs No antibiotics | OR 1.49 [1.08, 2.06] | 4 studies · 1235 participants | Moderate Downgraded: risk of bias |
Adverse effects of antibiotics (adverse effects) Delayed antibiotics vs No antibiotics | no estimate extracted | 2 studies · 566 participants | Moderate Downgraded: risk of bias |