Twenty-one RCTs (n=10,698) were included in the review. Two thirds of studies scored 4 or 5 points on the Jadad scale (mean 3.9 points). Only six studies described a satisfactory method of allocation concealment; the rest gave no information.
Short-term versus longer term antibiotics:
At early follow up, no statistically significant difference between the groups in rates of clinical cure was found (OR 0.99, 95% CI: 0.90, 1.08, 20 RCTs). Nor was there any difference between the groups in rates of bacteriological cure (OR 1.05, 95% CI: 0.87, 1.26, 18 RCTs). Similarly, at late follow up no statistically significant difference between the groups was found in rates of clinical cure (OR 1.0, 95% CI: 0.91, 1.10).
Subgroup analysis by antibiotic type found the odds ratios for early clinical cure were similar among different antibiotic classes. Sensitivity analyses found no statistically significant difference between the groups for the primary outcomes when analysis was restricted to high quality RCTs or RCTs using the same antibiotic in both arms.
No statistically significant heterogeneity was found nor was there any indication of publication bias.