A meta-analysis on the prophylactic use of macrolide antibiotics for the prevention of disease exacerbations in patients with Chronic Obstructive Pulmonary Disease

Donath, Elie; Chaudhry, Abubakr; Hernandez‐Aya, Leonel F.; Lit, Louis

doi:10.1016/j.rmed.2013.05.004

Cited by 61 publications

(36 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Participants in the SBHR coincided in their use of oral and inhaled antibiotics to treat CBC in patients with BE related to COPD, even though these treatment regimens are not included in the COPD treatment guidelines [36]. The effectiveness of long-term macrolides has been evaluated in COPD and BE with favourable results [37,38] but the use of other oral antibiotics to avoid exacerbations in COPD has had highly variable results: consequently, the systematic use of such drugs is not recommended at this time [39,40]. Only two studies have evaluated the use of inhaled antibiotics—tobramycin and levofloxacin—in a few COPD patients, with inconclusive results [41,42].…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of chronic obstructive pulmonary disease on non-cystic fibrosis bronchiectasis. A study on 1,790 patients from the Spanish Bronchiectasis Historical Registry

et al. 2017

View full text Add to dashboard Cite

BackgroundFew studies have evaluated the coexistence of bronchiectasis (BE) and chronic obstructive pulmonary disease (COPD) in series of patients diagnosed primarily with BE. The aim of this study was to analyse the characteristics of patients with BE associated with COPD included in the Spanish Bronchiectasis Historical Registry and compare them to the remaining patients with non-cystic fibrosis BE.MethodsWe conducted a multicentre observational study of historical cohorts, analysing the characteristics of 1,790 patients who had been included in the registry between 2002 and 2011. Of these, 158 (8.8%) were registered as BE related to COPD and were compared to the remaining patients with BE of other aetiologies.ResultsPatients with COPD were mostly male, older, had a poorer respiratory function and more frequent exacerbations. There were no differences in the proportion of patients with chronic bronchial colonisation or in the isolated microorganisms. A significantly larger proportion of patients with COPD received treatment with bronchodilators, inhaled steroids and intravenous antibiotics, but there was no difference in the use of long term oral or inhaled antibiotherapy. During a follow-up period of 3.36 years, the overall proportion of deaths was 13.8%. When compared to the remaining aetiologies, patients with BE associated with COPD presented the highest mortality rate. The multivariate analysis showed that the diagnosis of COPD in a patient with BE as a primary diagnosis increased the risk of death by 1.77.ConclusionPatients with BE related to COPD have the same microbiological characteristics as patients with BE due to other aetiologies. They receive treatment with long term oral and inhaled antibiotics aimed at controlling chronic bronchial colonisation, even though the current COPD treatment guidelines do not envisage this type of therapy. These patients’ mortality is notably higher than that of remaining patients with non-cystic fibrosis BE.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical impact of chronic obstructive pulmonary disease on non-cystic fibrosis bronchiectasis. A study on 1,790 patients from the Spanish Bronchiectasis Historical Registry

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In recent years, macrolide antibiotics have been explored in several clinical trials for their effects on patients with CLD, including COPD, asthma, cystic fibrosis (CF), and non CFbronchiectasis (3,(5)(6)(7)(8)(9)(10)(11)(12)(13). Recently, several meta-analyses collected the data and confirmed that the long-term use of macrolides improves the quality of life of CLD patients by improving lung function and decreasing the frequency of acute exacerbations (14,15). However, no study has focused on their detrimental effects, especially on microbiological aspects.…”

mentioning

confidence: 99%

Meta-Analysis of the Adverse Effects of Long-Term Azithromycin Use in Patients with Chronic Lung Diseases

Liu

Chen

et al. 2014

Antimicrob Agents Chemother

View full text Add to dashboard Cite

cThe adverse effects of azithromycin on the treatment of patients with chronic lung diseases (CLD) were evaluated in the present study. MEDLINE and other databases were searched for relevant articles published until August 2013. Randomized controlled trials that enrolled patients with chronic lung diseases who received long-term azithromycin treatment were selected, and data on microbiological studies and azithromycin-related adverse events were abstracted from articles and analyzed. Six studies were included in the meta-analysis. The risk of bacterial resistance in patients receiving long-term azithromycin treatment was increased 2.7-fold (risk ratio [

show abstract

“…107,108 It is important to draw attention to the heterogeneity of the antibiotic regimens and the background inhalation therapy evaluated in studies included in the meta-analysis (<50% of patients received double or triple therapy). 107,108 It is important to draw attention to the heterogeneity of the antibiotic regimens and the background inhalation therapy evaluated in studies included in the meta-analysis (<50% of patients received double or triple therapy).…”

Section: Summary Of the Evidencementioning

confidence: 99%

ALAT-2014 Chronic Obstructive Pulmonary Disease (COPD) Clinical Practice Guidelines: Questions and Answers

Varela

Acuña

et al. 2015

Archivos de Bronconeumología (English Edition)

View full text Add to dashboard Cite

A meta-analysis on the prophylactic use of macrolide antibiotics for the prevention of disease exacerbations in patients with Chronic Obstructive Pulmonary Disease

Abstract: Prophylactic macrolides are an effective approach for reducing incident COPD exacerbations. There were several limitations to this study including a lack of consistent adverse event reporting and some degree of clinical and statistical heterogeneity between studies.

Cited by 61 publications

References 18 publications

Clinical impact of chronic obstructive pulmonary disease on non-cystic fibrosis bronchiectasis. A study on 1,790 patients from the Spanish Bronchiectasis Historical Registry

Clinical impact of chronic obstructive pulmonary disease on non-cystic fibrosis bronchiectasis. A study on 1,790 patients from the Spanish Bronchiectasis Historical Registry

Meta-Analysis of the Adverse Effects of Long-Term Azithromycin Use in Patients with Chronic Lung Diseases

ALAT-2014 Chronic Obstructive Pulmonary Disease (COPD) Clinical Practice Guidelines: Questions and Answers

Contact Info

Product

Resources

About