Background: Everyone engaged in research knows that systematic reviews are the best study to map existing knowledge on intervention, prognosis and diagnosis of a certain disease. However, few studies have raised attention for the large number of reviews with insufficient evidence to answer the questions around therapeutic strategies for treatment and prevention of diseases. Infectious diseases (IDs) are associated with high morbidity and mortality. The best scientific evidence is an essential tool to control IDs.

Objectives: We evaluated the conclusions from all Cochrane systematic reviews related to IDs of randomized controlled trials (RCTs) in terms of their recommendations for clinical practice and research.

Methods: A cross-sectional study of systematic reviews published in the Cochrane Library (Issue 11, 2012) was conducted. We divided 5074 in two and did the selection in four authors (two pairs, disagreements settled by one author from the other pair) with the aim to select all reviews related to IDs.

Results: We analyzed 718 (14.2%) of the completed systematic reviews published in the Cochrane Library, Issue 11, 2012. This study has found that the majority of Cochrane Reviews related to IDs highlight the absence or poor evidence, i.e., lack of RCTs around the questions on health care that has been covered by them.

Conclusions: Cochrane systematic reviews related to infectious diseases are a great tool in the process of developing recommendations and making decision, however we cannot ruled out the overall absence of evidence found in our study and, we reaffirms the need for the conduction of higher-quality primary studies.