SynthesisArchives of disease in childhood1998
Systematic review of the treatment of upper respiratory tract infection.
Synthesis in Archives of disease in childhood, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Quality assessment of diagnosis and antibiotic treatment of infectious diseases in primary care: a systematic review of quality indicators.Scandinavian journal of primary health care · 2016Pooled it
- Antibiotics for preventing suppurative complications from undifferentiated acute respiratory infections in children under five years of age.The Cochrane database of systematic reviews · 2016Pooled it
- Common cold.BMJ clinical evidence · 2011Pooled it
- Common cold.BMJ clinical evidence · 2008Pooled it
- The natural history of acute cough in children aged 0 to 4 years in primary care: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2002Pooled it
- Trial
- Influence of acute upper respiratory tract infection on the absorption of inhaled insulin using the AERx insulin Diabetes Management System.British journal of clinical pharmacology · 2005Trial
- Modelling consultation rates in infancy: influence of maternal and infant characteristics, feeding type and consultation history.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Trial
- Antibiotic treatment for non-specific upper respiratory tract infections and exacerbation risk in children with asthma: a target trial emulation study.American journal of epidemiology · 2026Article
- C-reactive protein testing in primary care and antibiotic use in children with acute respiratory tract infections in Kyrgyzstan: an open-label, individually randomised, controlled trial.The Lancet regional health. Europe · 2025Article
- Antibiotic Usage for Treatment of Acute Upper Respiratory Tract Infections in Children in Lithuania from 2018 to 2022.Antibiotics (Basel, Switzerland) · 2025Article
- Exploring the Impact of Antibiotics on Fever Recovery Time and Hospital Stays in Children with Viral Infections: Insights from Advanced Data Analysis.Antibiotics (Basel, Switzerland) · 2024Article
- The Behavior of Primary Healthcare Doctors Toward Antibiotic Prescriptions for Upper Respiratory Tract Infections.Cureus · 2024Article
- COVID-19 restrictions and hygiene measures reduce the rates of respiratory infections and wheezing among preterm infants.Acta bio-medica : Atenei Parmensis · 2023Article
- Paediatric Deep Neck Infection-The Risk of Needing Intensive Care.Children (Basel, Switzerland) · 2022Review
- Spread of Respiratory Pathogens During the COVID-19 Pandemic Among Children in the Northeast of Italy.Frontiers in microbiology · 2022Article
- Wisconsin Upper Respiratory Symptom Survey for Kids: Validation of an Illness-specific Quality of Life Instrument.Pediatric research · 2021Article
- The Disappearance of Respiratory Viruses in Children during the COVID-19 Pandemic.International journal of environmental research and public health · 2021Article
- The effect of a mystery shopper scheme on prescribing behavior in primary care: Results from a field experiment.Health economics review · 2020Article
- Risk assessment and antibiotic prescribing decisions in children presenting to UK primary care with cough: a vignette study.BMJ open · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the risks and benefits of antibiotic treatment in children with symptoms of upper respiratory tract infection (URTI).
designQuantitative systematic review of randomised trials that compare antibiotic treatment with placebo. DATA SOURCES: Twelve trials retrieved from a systematic search (electronic databases, contact with authors, contact with drug manufacturers, reference lists); no restriction on language.
main outcome measuresThe proportion of children in whom the clinical outcome was worse or unchanged; the proportion of children who suffered complications or progression of illness; the proportion of children who had side effects.
results1699 children were randomised in six trials that contributed to the meta-analysis. Six trials were not used in the meta-analysis because of different outcomes or incomplete data. Clinical outcome was not improved by antibiotic treatment (relative risk 1.01, 95% confidence interval (CI) 0.90 to 1.13), neither was the proportion of children suffering from complications or progression of illness (relative risk 0.71, 95% CI 0.45 to 1.12). Complications from URTI in the five trials that reported this outcome was low (range 2-15%). Antibiotic treatment was not associated with an increase in side effects compared with placebo (relative risk 0.8, 95% CI 0.54 to 1.21).
conclusionsIn view of the lack of efficacy and low complication rates, antibiotic treatment of children with URTI is not supported by current evidence from randomised trials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.