دورية أكاديمية
The Efficacy and Safety of Inhaled Antibiotics for the Treatment of Bronchiectasis in Adults: Updated Systematic Review and Meta-Analysis.
| العنوان: | The Efficacy and Safety of Inhaled Antibiotics for the Treatment of Bronchiectasis in Adults: Updated Systematic Review and Meta-Analysis. |
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| المؤلفون: | Cordeiro R; Department of Pulmonology, Centro Hospitalar do Oeste, Torres Vedras, Portugal., Choi H; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea., Haworth CS; Cambridge Centre for Lung Infection, Royal Papworth Hospital NHS Foundation Trust, University of Cambridge, Cambridge, England; Department of Medicine, University of Cambridge, Cambridge, England., Chalmers JD; Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland. Electronic address: jchalmers@dundee.ac.uk. |
| المصدر: | Chest [Chest] 2024 Jul; Vol. 166 (1), pp. 61-80. Date of Electronic Publication: 2024 Feb 02. |
| نوع المنشور: | Systematic Review; Journal Article; Meta-Analysis |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 0231335 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1931-3543 (Electronic) Linking ISSN: 00123692 NLM ISO Abbreviation: Chest Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2016- : New York : Elsevier Original Publication: Chicago : American College of Chest Physicians |
| مواضيع طبية MeSH: | Bronchiectasis*/drug therapy , Anti-Bacterial Agents*/administration & dosage, Humans ; Administration, Inhalation ; Adult ; Quality of Life ; Treatment Outcome |
| مستخلص: | Background: Inhaled antibiotics are recommended conditionally by international bronchiectasis guidelines for the treatment of patients with bronchiectasis, but results of individual studies are inconsistent. A previous meta-analysis demonstrated promising results regarding the efficacy and safety of inhaled antibiotics in bronchiectasis. Subsequent publications have supplemented the existing body of evidence further in this area. Research Question: To what extent do inhaled antibiotics demonstrate both efficacy and safety as a treatment option for adults with bronchiectasis? Study Design and Methods: Systematic review and meta-analysis of randomized controlled trials of inhaled antibiotics in adult patients with bronchiectasis. We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov for eligible studies. Studies were included if they enrolled adults with bronchiectasis diagnosed by CT imaging and had a treatment duration of at least 4 weeks. The primary end point was exacerbation frequency, with additional key efficacy end points including severe exacerbations, bacterial load, symptoms, quality of life, and FEV Results: Twenty studies involving 3,468 patients were included. Inhaled antibiotics were associated with reduced number of patients with exacerbations (risk ratio, 0.85; 95% CI, 0.75-0.96), a slight reduction in exacerbation frequency (rate ratio [RR], 0.78; 95% CI, 0.68-0.91), a probable reduction in the frequency of severe exacerbations (RR, 0.48; 95% CI, 0.31-0.74), and a likely slight increase in time to first exacerbation (hazard ratio, 0.80; 95% CI, 0.68-0.94). Inhaled antibiotics likely lead to a slight increase in the Quality of Life Questionnaire-Bronchiectasis respiratory symptom score (mean difference, 2.51; 95% CI, 0.44-4.31) and may reduce scores on the St. George Respiratory Questionnaire (mean difference, -3.13; 95% CI, -5.93 to -0.32). Bacterial load consistently was reduced, but FEV Interpretation: In this systematic review and meta-analysis, inhaled antibiotics resulted in a slight reduction in exacerbations, a probable reduction in severe exacerbations, and a likely slight improvement in symptoms and quality of life in adults with bronchiectasis. Trial Registry: International Prospective Register of Systematic Reviews; No.: CRD42023384694; URL: https://www.crd.york.ac.uk/prospero/. Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: H. C. reports grants or contracts from the Korean Ministry of Education Basic Science Research Program [Grant 2021R1I1A3052416]; consulting fees from Boryung Pharmaceutical Co., Ltd.; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Boryung Pharmaceutical Co., Ltd. C. S. H. reports consulting fees from 30 Technology, Aradigm, CSL Behring, Chiesi, Gilead, Grifols, GSK, Insmed, Janssen, LifeArc, Meiji, Mylan, Novartis, Pneumagen, Shionogi, Teva, Vertex, and Zambon (personal fees); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Chiesi, Insmed; and payment for expert testimony from Zambon. J. D. C. has received research grants from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Gilead Sciences, Grifols, Novartis, Insmed, and Trudell and has received consultancy or speaker fees from Antabio, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Insmed, Janssen, Novartis, Pfizer, Trudell, and Zambon. None declared (R. C.). (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.) |
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| فهرسة مساهمة: | Keywords: antibiotics; bronchiectasis; inhalation; meta-analysis; therapeutics |
| المشرفين على المادة: | 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20240203 Date Completed: 20240710 Latest Revision: 20240718 |
| رمز التحديث: | 20240718 |
| مُعرف محوري في PubMed: | PMC11251083 |
| DOI: | 10.1016/j.chest.2024.01.045 |
| PMID: | 38309462 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1931-3543 |
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| DOI: | 10.1016/j.chest.2024.01.045 |