Background: Sex and gender differences are often not considered in research design, study implementation and reporting. This limits the applicability of research findings to decision making. Cochrane reviews are important to transfer research knowledge into policy and clinical practice. However, the lack of a sex and gender-based analysis (SGBA) in Cochrane reviews may represent a barrier to support informed decision making.

Objectives: To describe the extent to which SGBA is considered in Cochrane reviews of interventions for preventing healthcare-associated infections (HAIs).

Methods: Study design: ‘methodology study’. We searched the Cochrane Database of Systematic Reviews for active reviews published before 1 January 2017. We screened 6694 records and included those reviews evaluating any intervention attempting to prevent HAIs or healthcare colonisations. At least two reviewers independently participated in the selection and extraction processes by using predefined forms in EPPI-Reviewer 4 software. To extract key information about sex and gender we considered the domains of the ‘Sex and Gender in Systematic Reviews Planning Tool’ (SGSR-PT).

Results: A preliminary analysis of 59 included reviews showed that SGBA was generally absent. No review met all of the SGSR-PT criteria. Sex and gender terms were used interchangeably. The background never described the relevance of sex/gender to the review question and the data were disaggregated by sex in only 2 reviews. There were subgroup analyses by sex in only 3 reviews, and no review highlighted any sex/gender research gaps.

Conclusions: SGBA was practically absent in Cochrane reviews on prevention of HAIs. This raises concerns about the quality and applicability of these reviews, and highlights that there is much room for improvement to support informed decision making in this field.