Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes.
Population: Adults and children with acute uncomplicated respiratory infections
Intervention: Delayed antibiotic prescription (delay ranged from 48 hours–14 days)
Comparison: Immediate antibiotic prescription or no antibiotic prescription
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Delayed antibiotic prescription v immediate antibiotic prescription | ||
Clinical outcomes: pain, malaise, fever, and cough (follow‐up: 1–7 days) | See note ᵃ | Moderate |
Antibiotic use | Favors intervention | Moderate |
Patient satisfaction | No statistically significant difference | Moderate |
Antibiotic‐related adverse effects: diarrhea, vomiting, or rash (follow‐up: 1–7 days) | No statistically significant difference | Low |
Re‐consultation rate (follow‐up: not reported) | No statistically significant difference | Moderate |
Antibiotic resistance | None of the studies identified by the review assessed this outcome | |
Delayed antibiotic prescription v no antibiotic prescription | ||
Clinical outcomes: pain, fever, and cough (follow‐up: 1–7 days) | See note ᵃ | Moderate |
Antibiotic use | Favors comparison | Moderate |
Patient satisfaction | Favors intervention | Moderate |
Antibiotic‐related adverse effects: diarrhea, vomiting, or rash (follow‐up: 1–7 days) | See note ᵇ | Moderate |
Re‐consultation rate (follow‐up: not reported) | No statistically significant difference | Moderate |
Antibiotic resistance | None of the studies identified by the review assessed this outcome | |
Note Cochrane Clinical Answer (CCA) clinical interpretation: The choice of delayed antibiotic prescription over immediate antibiotics, and no antibiotics over delayed antibiotic prescription, reduces antibiotic use overall and appears to be safe and effective for adults and children with acute uncomplicated respiratory infection. ᵃ Studies were not pooled in a meta‐analysis; results reported narratively. In general, little or no effect on clinical outcomes was reported. See the CCA for more details. ᵇ Studies were not pooled in a meta-analysis; results reported narratively. Two RCTs found no statistically significant difference between treatment groups or reported no events in either group.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
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