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 respiratory infections
Intervention: Delayed antibiotic prescription (delay ranged from 48 hours to 14 days) ᵃ
Comparison: Immediate antibiotic prescription ᵃ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Clinical outcomes: assessed with pain, malaise, fever, and cough (follow‐up: 1-7 days) | See note ᵇ | Moderate |
Antibiotic use (follow‐up: 1-7 days) | Favors intervention | Moderate |
Patient satisfaction (follow‐up: 1-7 days) | No statistically significant difference | Moderate |
Antibiotic‐related adverse effects (follow‐up: 1-7 days): diarrhea or vomiting | See note ᵇ | Low |
Antibiotic‐related adverse effects (follow‐up: 1-7 days): rash | No statistically significant difference | See note ᶜ |
Reconsultation rate (time point unclear) | No statistically significant difference | Moderate |
Antibiotic resistance | - | None of the studies identified by the review assessed this outcome |
Note The Cochrane Clinical Answer (CCA) concludes that “when clinicians are not confident in prescribing no antibiotic, delayed prescription results in lower antibiotic use than immediate prescription”. ᵃ This evidence table summarizes the findings for the comparison of delayed antibiotic prescription versus immediate antibiotic prescription, which is the main comparison as stated in the Cochrane review Summary of Findings table. See the full CCA for information on other comparisons (delayed antibiotic prescription versus no antibiotic prescription). ᵇ Studies were not pooled in a meta‐analysis, results reported narratively. See the CCA for more details. ᶜ GRADE was not reported for rash alone. Overall GRADE for antibiotic‐related adverse effects was low. However, this included being downgraded for inconsistency of results for vomiting and diarrhea. See CCA and Cochrane review Summary of Findings table for more details.
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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