Delayed antibiotics for respiratory infections.

Abstract:

BACKGROUND:Concerns exist regarding antibiotic prescribing for acute respiratory tract infections (ARTIs) owing to adverse reactions, cost and antibacterial resistance. One strategy to reduce antibiotic prescribing is to provide prescriptions but to advise delay in the hope symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007 and updated in 2010. OBJECTIVES:To evaluate the use of delayed antibiotics compared to immediate or no antibiotics as a prescribing strategy for ARTIs. We evaluated clinical outcomes including duration and severity measures for pain, malaise, fever, cough and rhinorrhoea in sore throat, acute otitis media, bronchitis (cough) and the common cold. We also evaluated the outcomes of antibiotic use, patient satisfaction, antibiotic resistance and re-consultation rates and use of alternative therapies. SEARCH METHODS:We searched CENTRAL (The Cochrane Library 2013, Issue 2), which includes the Acute Respiratory Infection Group's Specialised Register; Ovid MEDLINE (January 1966 to February Week 3 2013); Ovid MEDLINE In-Process & Other Non-Indexed Citations (28 February 2013); EMBASE (1990 to 2013 Week 08); Science Citation Index - Web of Science (2007 to May 2012) and EBSCO CINAHL (1982 to 28 February 2013). SELECTION CRITERIA:Randomised controlled trials (RCTs) involving participants of all ages defined as having an ARTI, where delayed antibiotics were compared to antibiotics used immediately or no antibiotics. DATA COLLECTION AND ANALYSIS:Three review authors independently extracted and collected data. Important adverse effects, including adverse effects of antibiotics and complications of disease, were included as secondary outcomes. We assessed the risk of bias of all included trials. We contacted trial authors to obtain missing information where available. MAIN RESULTS:Ten studies, with a total of 3157 participants, were included in this review. Heterogeneity of the 10 included studies and their results generally precluded meta-analysis with patient satisfaction being an exception.There was no difference between delayed, immediate and no prescribed antibiotics for the clinical outcomes evaluated in cough and common cold. In patients with acute otitis media (AOM) and sore throat immediate antibiotics were more effective than delayed for fever, pain and malaise in some studies. There were only minor differences in adverse effects with no significant difference in complication rates.Delayed antibiotics resulted in a significant reduction in antibiotic use compared to immediate antibiotics. A strategy of no antibiotics resulted in least antibiotic use.Patient satisfaction favoured immediate antibiotics over delayed (odds ratio (OR) 0.52; 95% confidence interval (CI) 0.35 to 0.76). Delayed and no antibiotics had similar satisfaction rates with both strategies achieving over 80% satisfaction (OR 1.44; 95% CI 0.99 to 2.10).There was no difference in re-consultation rates for immediate and delayed groups.None of the included studies evaluated antibiotic resistance. AUTHORS' CONCLUSIONS:Most clinical outcomes show no difference between strategies. Delay slightly reduces patient satisfaction compared to immediate antibiotics (87% versus 92%) but not compared to none (87% versus 83%). In patients with respiratory infections where clinicians feel it is safe not to prescribe antibiotics immediately, no antibiotics with advice to return if symptoms do not resolve is likely to result in the least antibiotic use, while maintaining similar patient satisfaction and clinical outcomes to delayed antibiotics.

authors

Spurling GK,Del Mar CB,Dooley L,Foxlee R,Farley R

doi

10.1002/14651858.CD004417.pub4

subject

Has Abstract

pub_date

2013-04-30 00:00:00

pages

CD004417

issue

4

issn

1469-493X

pub_type

杂志文章,meta分析,评审
  • Inhaled analgesia for pain management in labour.

    abstract:BACKGROUND:Many women would like to have a choice in pain relief during labour and also would like to avoid invasive methods of pain management in labour. Inhaled analgesia during labour involves the self-administered inhalation of sub-anaesthetic concentrations of agents while the mother remains awake and her protecti...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009351.pub2

    authors: Klomp T,van Poppel M,Jones L,Lazet J,Di Nisio M,Lagro-Janssen AL

    更新日期:2012-09-12 00:00:00

  • WITHDRAWN: Follicle-stimulating hormone and human menopausal gonadotropin for ovarian stimulation in assisted reproduction cycles.

    abstract:BACKGROUND:Both human menopausal gonadotropin (hMG) and human follicle stimulating hormone (hFSH) have been used successfully for ovarian stimulation, but the relative importance of FSH and luteinizing hormone (LH) in follicular growth and maturation has been the subject of much debate. OBJECTIVES:To conduct a systema...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000061

    authors: Daya S

    更新日期:1996-04-22 00:00:00

  • Interactive computer-based interventions for sexual health promotion.

    abstract:BACKGROUND:Sexual health promotion is a major public health challenge; there is huge potential for health promotion via technology such as the Internet. OBJECTIVES:To determine effects of interactive computer-based interventions (ICBI) for sexual health promotion, considering cognitive, behavioural, biological and eco...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD006483.pub2

    authors: Bailey JV,Murray E,Rait G,Mercer CH,Morris RW,Peacock R,Cassell J,Nazareth I

    更新日期:2010-09-08 00:00:00

  • Thyroid hormones for acute kidney injury.

    abstract:BACKGROUND:Acute kidney injury (AKI), which is common in hospitalised patients, is associated with significant morbidity and mortality. Despite recent advances in treatment, AKI outcomes have not changed substantially during the past four decades, and incidence is increasing. There is an urgent need to explore novel th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD006740.pub2

    authors: Nigwekar SU,Strippoli GF,Navaneethan SD

    更新日期:2013-01-31 00:00:00

  • Oestrogens alone or with amniotomy for cervical ripening or induction of labour.

    abstract:BACKGROUND:Studies in sheep showed that there is a pre-labour rise in oestrogen and a decrease in progesterone, both of these changes stimulate prostaglandin production and may help initiate labour. Though oestrogen has been suggested as an effective cervical ripening or induction agent, research in humans have failed ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003393

    authors: Thomas J,Kelly AJ,Kavanagh J

    更新日期:2001-01-01 00:00:00

  • Screening for colorectal cancer using the faecal occult blood test, hemoccult.

    abstract:BACKGROUND:Colorectal cancer is a leading cause of illness and death in the Western world. In Australia, the United Kingdom and the United States, it is the second commonest cancer for women after breast cancer (age-standardised incidence 22-33 per 100,000), and men after prostate or lung cancer (age-standardised incid...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001216

    authors: Towler BP,Irwig L,Glasziou P,Weller D,Kewenter J

    更新日期:2000-01-01 00:00:00

  • Decision aids for people facing health treatment or screening decisions.

    abstract:BACKGROUND:Decision aids are interventions designed to help people make specific and deliberative choices among options (including status quo) by providing (at a minimum) information on the options and outcomes relevant to a person's health status. A systematic review is needed to summarize what is known about their ef...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001431

    authors: O'Connor AM,Stacey D,Rovner D,Holmes-Rovner M,Tetroe J,Llewellyn-Thomas H,Entwistle V,Rostom A,Fiset V,Barry M,Jones J

    更新日期:2001-01-01 00:00:00

  • Phonics training for English-speaking poor readers.

    abstract:BACKGROUND:Around 5% of English speakers have a significant problem with learning to read words. Poor word readers are often trained to use letter-sound rules to improve their reading skills. This training is commonly called phonics. Well over 100 studies have administered some form of phonics training to poor word rea...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009115.pub2

    authors: McArthur G,Eve PM,Jones K,Banales E,Kohnen S,Anandakumar T,Larsen L,Marinus E,Wang HC,Castles A

    更新日期:2012-12-12 00:00:00

  • Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function.

    abstract:BACKGROUND:Hydroxyethyl starches (HES) are synthetic colloids commonly used for fluid resuscitation, yet controversy exists about their impact on kidney function. OBJECTIVES:To examine the effects of HES on kidney function compared to other fluid resuscitation therapies in different patient populations. SEARCH STRATE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007594.pub2

    authors: Dart AB,Mutter TC,Ruth CA,Taback SP

    更新日期:2010-01-20 00:00:00

  • Milnacipran for neuropathic pain and fibromyalgia in adults.

    abstract:BACKGROUND:Milnacipran is a serotonin-norepinephrine reuptake inhibitor (SNRI) that is sometimes used to treat chronic neuropathic pain and fibromyalgia. OBJECTIVES:To evaluate the analgesic efficacy and adverse effects of milnacipran in the management of chronic neuropathic pain or fibromyalgia. SEARCH METHODS:We se...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008244.pub2

    authors: Derry S,Gill D,Phillips T,Moore RA

    更新日期:2012-03-14 00:00:00

  • Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants.

    abstract:BACKGROUND:Respiratory failure due to lung immaturity is a major cause of mortality in preterm infants. Although the use of intermittent positive pressure ventilation (IPPV) in neonates with respiratory failure saves lives, its use is associated with lung injury and chronic lung disease (CLD). Conventional IPPV is prov...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD000104.pub2

    authors: Henderson-Smart DJ,Cools F,Bhuta T,Offringa M

    更新日期:2007-07-18 00:00:00

  • Telephone counselling for smoking cessation.

    abstract:BACKGROUND:Telephone services can provide information and support for smokers. Counselling may be provided proactively or offered reactively to callers to smoking cessation helplines. OBJECTIVES:To evaluate the effect of telephone support to help smokers quit, including proactive or reactive counselling, or the provis...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章

    doi:10.1002/14651858.CD002850.pub4

    authors: Matkin W,Ordóñez-Mena JM,Hartmann-Boyce J

    更新日期:2019-05-02 00:00:00

  • Continuous passive motion following total knee arthroplasty in people with arthritis.

    abstract:BACKGROUND:Total knee arthroplasty is a common intervention for patients with arthritis. Post-surgical rehabilitation often includes continuous passive motion. However, it is not clear whether continuous passive motion is effective. OBJECTIVES:To evaluate the effectiveness of continuous passive motion following total ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004260.pub2

    authors: Harvey LA,Brosseau L,Herbert RD

    更新日期:2010-03-17 00:00:00

  • Elective repeat caesarean section versus induction of labour for women with a previous caesarean birth.

    abstract:BACKGROUND:When a woman has had a previous caesarean birth and requires induction of labour in a subsequent pregnancy there are two options for her care, an elective repeat caesarean or planned induction of labour. While there are risks and benefits for both elective repeat caesarean birth and planned induction of labo...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004906.pub4

    authors: Dodd JM,Crowther CA,Grivell RM,Deussen AR

    更新日期:2014-12-19 00:00:00

  • Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion.

    abstract:BACKGROUND:Concerns regarding the safety of transfused blood have led to the development of a range of interventions to minimise blood loss during major surgery. Anti-fibrinolytic drugs are widely used, particularly in cardiac surgery, and previous reviews have found them to be effective in reducing blood loss, the nee...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001886.pub3

    authors: Henry DA,Carless PA,Moxey AJ,O'Connell D,Stokes BJ,Fergusson DA,Ker K

    更新日期:2011-01-19 00:00:00

  • Antibiotics for treating osteomyelitis in people with sickle cell disease.

    abstract:BACKGROUND:Osteomyelitis (both acute and chronic) is one of the most common infectious complications in people with sickle cell disease. There is no standardized approach to antibiotic therapy and treatment is likely to vary from country to country. Thus, there is a need to identify the efficacy and safety of different...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007175.pub3

    authors: Martí-Carvajal AJ,Agreda-Pérez LH

    更新日期:2012-12-12 00:00:00

  • WITHDRAWN: Hypnosis for children undergoing dental treatment.

    abstract:BACKGROUND:Managing children is a challenge that many dentists face. Many non-pharmacological techniques have been developed to manage anxiety and behavioural problems in children, such us: 'tell, show & do', positive reinforcement, modelling and hypnosis. The use of hypnosis is generally an overlooked area, hence the ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007154.pub3

    authors: Al-Harasi S,Ashley PF,Moles DR,Parekh S,Walters V

    更新日期:2017-06-20 00:00:00

  • Techniques of monitoring blood glucose during pregnancy for women with pre-existing diabetes.

    abstract:BACKGROUND:Self-monitoring of blood glucose (SMBG) is recommended as a key component of the management plan for diabetes therapy during pregnancy. No existing systematic reviews consider the benefits/effectiveness of various techniques of blood glucose monitoring on maternal and infant outcomes among pregnant women wit...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009613.pub3

    authors: Moy FM,Ray A,Buckley BS,West HM

    更新日期:2017-06-11 00:00:00

  • Inhaled steroids for acute asthma following emergency department discharge.

    abstract:BACKGROUND:Patients with acute asthma treated in the emergency department (ED) are frequently treated with inhaled beta(2)-agonists and systemic corticosteroids after discharge. The use of inhaled corticosteroids (ICS) following discharge may also be beneficial in improving patient outcomes after acute asthma. OBJECTI...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002316.pub2

    authors: Edmonds ML,Milan SJ,Brenner BE,Camargo CA Jr,Rowe BH

    更新日期:2012-12-12 00:00:00

  • Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.

    abstract:BACKGROUND:Although highly effective in the treatment of obstructive sleep apnoea (OSA), continuous positive airway pressure (CPAP) is not universally accepted by users. Educational, supportive and behavioural interventions may help people with OSA initiate and maintain regular and continued use of CPAP. OBJECTIVES:To...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD007736.pub3

    authors: Askland K,Wright L,Wozniak DR,Emmanuel T,Caston J,Smith I

    更新日期:2020-04-07 00:00:00

  • Laparoscopic versus open liver resection for benign and malignant hepatic lesions in adults.

    abstract:BACKGROUND:Liver (hepatic) resection refers to removal of the whole liver, or one or more of its vascular segments. Elective liver resection is mainly performed for benign and malignant liver tumours. The operation can be performed as an open procedure or with a laparoscopic approach. With the advancement of laparoscop...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD010162.pub2

    authors: Rao AM,Ahmed I

    更新日期:2013-05-31 00:00:00

  • Non-nutritive sucking for gastro-oesophageal reflux disease in preterm and low birth weight infants.

    abstract:BACKGROUND:Gastro-oesophageal reflux (GOR) is commonly diagnosed in the neonatal population (DiPietro 1994), and generally causes few or no symptoms (Vandenplas 2009). Conversely, gastro-oesophageal reflux disease (GORD) refers to GOR that causes troublesome symptoms with or without complications such as damage to the ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD009817.pub2

    authors: Psaila K,Foster JP,Richards R,Jeffery HE

    更新日期:2014-10-15 00:00:00

  • Day three versus day two embryo transfer following in vitro fertilization or intracytoplasmic sperm injection.

    abstract:BACKGROUND:Embryo transfer (ET) was traditionally performed two days after oocyte retrieval; however, developments in culture media have allowed embryos to be maintained in culture for longer periods. Delaying transfer from Day two to Day three would allow for further development of the embryo and might have a positive...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004378.pub3

    authors: Brown J,Daya S,Matson P

    更新日期:2016-12-14 00:00:00

  • Topical rubefacients for acute and chronic pain in adults.

    abstract:BACKGROUND:Rubefacients (containing salicylates or nicotinamides) cause irritation of the skin, and are believed to relieve various musculoskeletal pains. They are available on prescription, and are common components in over-the-counter remedies. A non-Cochrane review in 2004 found limited evidence for efficacy. OBJEC...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007403.pub2

    authors: Matthews P,Derry S,Moore RA,McQuay HJ

    更新日期:2009-07-08 00:00:00

  • Prophylactic antibiotic therapy for chronic bronchitis.

    abstract:BACKGROUND:The use of prophylactic antibiotics to reduce the frequency and severity of acute exacerbations of chronic bronchitis is controversial. OBJECTIVES:To determine if prophylactic antibiotics reduce the frequency of exacerbations and/or days of disability in subjects with chronic bronchitis. SEARCH STRATEGY:We...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004105

    authors: Staykova T,Black PN,Chacko EE,Poole P

    更新日期:2003-01-01 00:00:00

  • Reduction in saturated fat intake for cardiovascular disease.

    abstract:BACKGROUND:Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJE...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011737.pub2

    authors: Hooper L,Martin N,Jimoh OF,Kirk C,Foster E,Abdelhamid AS

    更新日期:2020-05-19 00:00:00

  • Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings.

    abstract:BACKGROUND:Ageing has a degenerative effect on the skin, leaving it more vulnerable to damage. Hygiene and emollient interventions may help maintain skin integrity in older people in hospital and residential care settings; however, at present, most care is based on "tried and tested" practice, rather than on evidence. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析

    doi:10.1002/14651858.CD011377.pub2

    authors: Cowdell F,Jadotte YT,Ersser SJ,Danby S,Lawton S,Roberts A,Dyson J

    更新日期:2020-01-23 00:00:00

  • Trifluoperazine for schizophrenia.

    abstract:BACKGROUND:Trifluoperazine is an inexpensive accessible 'high potency' antipsychotic drug, widely used to treat schizophrenia or related psychoses. OBJECTIVES:To estimate the effects of trifluoperazine compared with placebo and other drugs. SEARCH STRATEGY:Searches of the Cochrane Schizophrenia Group's register of tr...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD003545.pub2

    authors: Marques LO,Lima MS,Soares BG

    更新日期:2004-01-01 00:00:00

  • Multicomponent fortification of human breast milk for preterm infants following hospital discharge.

    abstract:BACKGROUND:Preterm infants are usually growth restricted at hospital discharge. Feeding preterm infants after hospital discharge with nutrient-fortified breast milk (rather than unfortified breast milk) may facilitate more rapid catch-up growth and improve neurodevelopmental outcomes. OBJECTIVES:To determine the effec...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004866.pub2

    authors: Henderson G,Fahey T,McGuire W

    更新日期:2007-10-17 00:00:00

  • Combination inhaled steroid and long-acting beta(2)-agonist in addition to tiotropium versus tiotropium or combination alone for chronic obstructive pulmonary disease.

    abstract:BACKGROUND:The long-acting bronchodilator tiotropium and single inhaler combination therapy of inhaled corticosteroids and long-acting beta(2)-agonists are both commonly used for maintenance treatment of chronic obstructive pulmonary disease. Combining these treatments, which have different mechanisms of action, may be...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008532.pub2

    authors: Karner C,Cates CJ

    更新日期:2011-03-16 00:00:00