Five studies with 534 participants (264 participants in the intervention group treated with antibiotic prophylaxis for 4 to 10 days, and 270 untreated participants in the control group).
Methodological quality ranged from 13 points to 18 points.
There was significant heterogeneity in the results in the control groups (p = 0.008) for the free-of-infection end-point. Antibiotic prophylaxis significantly increased the mean percentage of patients free of infection. The mean percentage of patients free of infection was 86% in the intervention group versus 55% in the control group with OR = 4.64, 95% CI: 3.19, 6.75, p < 0.001 (Peto) and 32% mean improvement rate, 95% CI: 22.6, 42.0; p < 0.001 (DerSimonian). There was no significant heterogeneity by both methods.
There was significant heterogeneity in the results in the control groups (p = 0.008) for the percentage of patients free of SBP and/or bacteremia end-points. Antibiotic prophylaxis significantly increased the mean percentage of patients free of SBP and/or bacteremia. The mean percentage of patients free of SBP and/or bacteremia was 92% in the intervention group versus 73% in the control group with OR = 3.86, 95% CI: 2.45, 6.06, p < 0.001 (Peto) and 18.5% mean improvement rate, 95% CI: 11.4, 25.6; p < 0.001 (DerSimonian). There was no significant heterogeneity by both methods.
There was no significant heterogeneity in the results in the control groups for the percentage of patients free of SBP end-points (3 trials). Antibiotic prophylaxis significantly increased the mean percentage of patients free of SBP and/or bacteremia. The mean percentage of patients free of SBP and/or bacteremia was 95% in the intervention group versus 87% in the control group with OR = 2.84, 95% CI: 1.42, 5.69, p < 0.003 (Peto) and 7.4% mean improvement rate, 95% CI: 2.1, 12.6; p < 0.006 (DerSimonian). There was no significant heterogeneity by both methods.
There was no significant heterogeneity in the results in the control groups for the survival rate end-point. Antibiotic prophylaxis significantly increased the survival rate. The mean survival rate was 85% in the intervention group versus 76% in the control group with OR = 1.88, 95% CI: 1.22, 2.89, p < 0.04 (Peto) and 9.1% mean rate difference, 95% CI: 2.9, 15.3; p < 0.004 (DerSimonian).
Adverse events were mentioned in 3 RCTs (4 patients reported diarrhoea in the intervention group). There were no adverse events reported in the control groups.