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The Efficacy and Safety of Inhaled Antibiotics for the Treatment of Bronchiectasis in Adults

Ricardo Cordeiro, Hayoung Choi, Charles Haworth, James D. Chalmers

2024CHEST Journal53 citationsDOIOpen Access PDF

Abstract

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: . Data were pooled through random-effects meta-analysis. RESULTS: was not changed with treatment. Evidence suggests little to no difference in adverse effects between groups (OR, 0.99; 95% CI, 0.75-1.30). Antibiotic-resistant organisms likely were increased by treatment. 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/.

Topics & Concepts

MedicineBronchiectasisExacerbationMeta-analysisRelative riskAntibioticsInternal medicineRandomized controlled trialHazard ratioConfidence intervalIntensive care medicineLungMicrobiologyBiologyCystic Fibrosis Research AdvancesNeonatal Respiratory Health ResearchChronic Obstructive Pulmonary Disease (COPD) Research
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