Head-to-head trials of antibiotics for bronchiectasis

Kaehne, Axel; Milan, Stephen J; Felix, Lambert; Sheridan, Emer; Marsden, Paul; Spencer, Sally

doi:10.1002/14651858.cd012590.pub2

Cited by 10 publications

(5 citation statements)

References 67 publications

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“…This would make antibiotic therapy potentially more effective in the early infection stage [ 69 ]. Unfortunately, there is so far no direct evidence of this hypothesis in bronchiectasis [ 94 , 95 ].…”

Section: Role Of Antibiotic Therapymentioning

confidence: 99%

Antimicrobial Resistance in Common Respiratory Pathogens of Chronic Bronchiectasis Patients: A Literature Review

et al. 2021

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Non-cystic fibrosis bronchiectasis is a chronic disorder in which immune system dysregulation and impaired airway clearance cause mucus accumulation and consequent increased susceptibility to lung infections. The presence of pathogens in the lower respiratory tract causes a vicious circle resulting in impaired mucociliary function, bronchial inflammation, and progressive lung injury. In current guidelines, antibiotic therapy has a key role in bronchiectasis management to treat acute exacerbations and chronic infection and to eradicate bacterial colonization. Contrastingly, antimicrobial resistance, with the risk of multidrug-resistant pathogen development, causes nowadays great concern. The aim of this literature review was to assess the role of antibiotic therapy in bronchiectasis patient management and possible concerns regarding antimicrobial resistance based on current evidence. The authors of this review stress the need to expand research regarding bronchiectasis with the aim to assess measures to reduce the rate of antimicrobial resistance worldwide.

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Section: Role Of Antibiotic Therapymentioning

confidence: 99%

Antimicrobial Resistance in Common Respiratory Pathogens of Chronic Bronchiectasis Patients: A Literature Review

et al. 2021

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“…Despite weak empirical evidence and the lack of success of several large clinical trials in bronchiectasis, antibiotics remain a therapeutic option for the treatment of bronchiectasis associated infection in selected patients [32,49]. Disappointing outcomes seen in clinical trials investigating inhaled antibiotic formulations raise concerns over trial design itself as well as our appreciation of disease complexity and heterogeneity.…”

Section: Antimicrobial Therapymentioning

confidence: 99%

Bronchiectasis and cough: An old relationship in need of renewed attention

Aogáin

Chotirmall

2019

Pulmonary Pharmacology & Therapeutics

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A B S T R A C TBronchiectasis is an increasingly recognised respiratory condition with limited therapeutic options and a complex spectrum of clinical manifestations that invariably includes chronic cough. As the primary presentation of bronchiectasis in most cases, chronic cough and its mechanistic underpinnings are of central importance but remain poorly understood in this setting. Bronchiectasis is also increasingly identified as an underlying cause of chronic cough highlighting the interrelationship between the two conditions that share overlapping clinical features. Several therapeutic approaches have illustrated positive effects on bronchiectasis-associated cough, however, more focused treatment of heterogeneous cough subtypes may yield better outcomes for patients. A current challenge is the identification of bronchiectasis and cough endophenotypes that may allow improved patient stratification and more targeted therapeutic matching of the right treatment to the right patient. Here we discuss the complex disease phenotypes of bronchiectasis and their interrelationship with cough while considering current and emerging treatment options. We discuss some key cough promoters in bronchiectasis including infection, allergy and immune dysfunction.

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“…Many antibiotics are developed for the control of bacterial infection during the exacerbations of bronchiectasis [ 11 – 13 ]. Growing evidences indicated that some drugs provided beneficial effects.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of azithromycin to prevent exacerbation of non-cystic fibrosis bronchiectasis: a meta-analysis of randomized controlled studies

Liu²,

Ou³

2022

J Cardiothorac Surg

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Introduction The efficacy of azithromycin to prevent exacerbation for non-cystic fibrosis bronchiectasis remains controversial. We conduct this meta-analysis to explore the influence of azithromycin versus placebo for the treatment of non-cystic fibrosis bronchiectasis. Methods We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through July 2019 for randomized controlled trials (RCTs) assessing the efficacy of azithromycin versus placebo for non-cystic fibrosis bronchiectasis. This meta-analysis was performed using the random-effect model. Results Four RCTs were included in the meta-analysis. Overall, compared with control group for non-cystic-fibrosis bronchiectasis, azithromycin treatment was associated with improved free of exacerbation (odd ratios [OR] = 3.66; 95% confidence interval [CI] = 1.69–7.93; P = 0.001), reduced pulmonary exacerbations (OR = 0.27; 95% CI 0.13–0.59; P = 0.001) and number of pulmonary exacerbations (standard mean difference [SMD] = − 0.87; 95% CI − 1.21 to − 0.54; P < 0.00001), but demonstrate no obvious impact on forced expiratory volume in 1 s (FEV1), score on St George’s respiratory questionnaire, nausea or vomiting, adverse events. Conclusions Azithromycin is effective to prevent exacerbation of non-cystic fibrosis bronchiectasis.

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Head-to-head trials of antibiotics for bronchiectasis

Cited by 10 publications

References 67 publications

Antimicrobial Resistance in Common Respiratory Pathogens of Chronic Bronchiectasis Patients: A Literature Review

Antimicrobial Resistance in Common Respiratory Pathogens of Chronic Bronchiectasis Patients: A Literature Review

Bronchiectasis and cough: An old relationship in need of renewed attention

The efficacy of azithromycin to prevent exacerbation of non-cystic fibrosis bronchiectasis: a meta-analysis of randomized controlled studies

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