Summary of findings 2. 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 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 (clinical outcomes) assessed with: pain, fever, cough, nasal mucosity, follow‐up: range 1 days to 16 days | 4 studies measured clinical outcomes for this comparison. 2 studies recruited participants with sore throat, one study recruited participants with otitis media, and 1 study recruited participants with cough, and for these studies there was no evidence of differences found. 1 study recruited participants with the common cold, and found results favouring delayed antibiotics for pain, fever, and cough duration, but no evidence of difference for nasal mucosity | ‐ | 955 (4 RCTs) | ⊕⊕⊕⊝ MODERATEa | ||
| Antibiotic use: delayed versus no antibiotics | 137 per 1000 | 287 per 1000 (201 to 392) | OR 2.55 (1.59 to 4.08) | 1241 (4 RCTs) | ⊕⊕⊕⊝ MODERATEa | |
| Patient satisfaction: delayed versus no antibiotics | 824 per 1000 | 875 per 1000 (835 to 906) | OR 1.49 (1.08 to 2.06) | 1235 (4 RCTs) | ⊕⊕⊕⊝ MODERATEa | |
| Adverse effects of antibiotics (adverse effects) assessed with: vomiting, diarrhoea, rash, follow‐up: range 1 days to 7 days | 2 studies measured adverse effects. 1 recruited participants with sore throat, and 1 with otitis media. Neither study found any difference in adverse effects | ‐ | 566 (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; RR: risk ratio; OR: odds ratio | ||||||
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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. | ||||||
aDowngraded 1 level for inadequate blinding for all studies, and allocation concealment not adequately reported for more than half of studies