Macrolide therapy in adults and children with non-cystic fibrosis bronchiectasis: a systematic review and meta-analysis

A systematic review and meta-analysis was conducted to evaluate the efficacy and safety of macrolide therapy in adults and children with bronchiectasis. We searched the PUBMED, EMBASE, CENTRAL databases to identify relevant studies. Two reviewers evaluated the studies and extracted data independentl...

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Bibliographic Details
Published in:PloS one 2014-03, Vol.9 (3), p.e90047
Main Authors: Gao, Yong-Hua, Guan, Wei-Jie, Xu, Gang, Tang, Yan, Gao, Yang, Lin, Zhi-Ya, Lin, Zhi-Min, Zhong, Nan-Shan, Chen, Rong-Chang
Format: Article
Language:English
Subjects:
Adult
Adults
Analysis
Antibiotics
Antimicrobial resistance
Bronchiectasis
Bronchiectasis - drug therapy
Bronchiectasis - physiopathology
Care and treatment
Child
Children
Chronic obstructive pulmonary disease
Clinical trials
Cystic fibrosis
Diarrhea
Diarrhea - chemically induced
Evidence-based medicine
Humans
Macrolides - adverse effects
Macrolides - therapeutic use
Medical ethics
Medicine
Meta-analysis
Patients
Quality of Life
Randomized Controlled Trials as Topic
Respiratory Function Tests
Studies
Systematic review
Therapy
Treatment Outcome
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Summary:A systematic review and meta-analysis was conducted to evaluate the efficacy and safety of macrolide therapy in adults and children with bronchiectasis. We searched the PUBMED, EMBASE, CENTRAL databases to identify relevant studies. Two reviewers evaluated the studies and extracted data independently. The primary outcome was the number of bronchiectasis exacerbations. Secondary outcomes included exacerbation-related admissions, quality of life (QoL), spirometry, 6-minute walk test (6MWT) and adverse events. Nine eligible trials with 559 participants were included. Six were conducted on adults, and the remaining on children. Macrolide therapy significantly reduced the number of patients experiencing one or more exacerbation in adults [risk ratio (RR) = 0.59; 95% CI, 0.40 to 0.86; P = 0.006; I2 = 65%] and children [RR = 0.86; 95% CI, 0.75-0.99; P = 0.04; I2 = 0%], but not the number of patients with admissions for exacerbation. Macrolide therapy was also associated with reduced frequency of exacerbations in adults (RR = 0.42; 95% CI, 0.29 to 0.61; P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0090047