Summary of findings 2. Summary of findings table ‐ Delayed antibiotics compared to no antibiotics for respiratory infections.

Delayed antibiotics compared to no antibiotics for respiratory infections
Patient or population: respiratory infections Setting: primary care, emergency department, paediatric outpatients Intervention: delayed antibiotics Comparison: no antibiotics
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)	Comments
	Risk with no antibiotics	Risk with delayed antibiotics
Clinical outcomes: pain, malaise, fever follow‐up: range 1 days to 7 days	5 studies measured clinical outcomes for this comparison. 3 studies recruited participants with sore throat (pharyngitis), 2 studies recruited participants with acute otitis media and 2 studies recruited participants with cough (bronchitis); for these studies there was no evidence of differences found. 1 study recruited participants with the common cold and results favoured delayed antibiotics (prescription at time of visit) for duration of pain and fever, and delayed antibiotics (prescription collection) for duration of fever and cough.			1685 (5 RCTs)	⊕⊕⊕⊝ Moderatea
Duration of clinical outcomes (pain, malaise, fever)	2 studies measured duration of clinical outcomes and contributed to this comparison. Pain: 2 studies measured duration of pain associated with sore throat (pharyngitis) and found no evidence of difference. 1 study measured duration of pain associated with acute otitis media and found no evidence of difference. Malaise: 2 studies measured duration of malaise. Results favoured delayed over no antibiotics for duration of malaise when the prescription was collected (prescription collection) (1 study), but no difference in duration of malaise between delayed and no antibiotics when the prescription was given at the time of visit. Fever: 2 studies measured duration of fever. 1 study found no evidence of difference in duration of fever associated with pharyngitis, and the other study found results favoured delayed over no antibiotics.			585 (2 RCTs)	⊕⊕⊕⊝ Moderatea
Antibiotic use: delayed (all strategies) versus no antibiotics	133 per 1000	279 per 1000 (206 to 365)	OR 2.52 (1.69 to 3.75)	1529 (5 RCTs)	⊕⊕⊕⊝ Moderatea
Patient satisfaction: delayed (prescription collection) versus no antibiotics	841 per 1000	885 per 1000 (851 to 912)	OR 1.45 (1.08 to 1.96)	1523 (5 RCTs)	⊕⊕⊕⊝ Moderatea
Reconsultation rate: delayed (all strategies) versus no antibiotics	96 per 1000	81 per 1000 (46 to 139)	OR 0.83 (0.46 to 1.52)	584 (2 RCTs)	⊕⊕⊕⊝ Moderatea
Adverse effects of antibiotics (diarrhoea, vomiting, rash): delayed versus no antibiotics follow‐up: range 1 days to 7 days	2 studies measured adverse effects: 1 recruited participants with sore throat and 1 with acute otitis media. Neither study found any difference in adverse effects.			674 (2 RCTs)	⊕⊕⊕⊝ Moderatea
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.
See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_439286631830684374.

^a Downgraded 1 level because more than half of the studies were not adequately blinded and did not report allocation concealment.