Elsevier

Journal of Cystic Fibrosis

Volume 11, Issue 5, September 2012, Pages 419-426
Journal of Cystic Fibrosis

Original Article
A network meta-analysis of the efficacy of inhaled antibiotics for chronic Pseudomonas infections in cystic fibrosis

https://doi.org/10.1016/j.jcf.2012.03.010Get rights and content
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open access

Abstract

Background

Various inhaled antibiotics are currently used for treating chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients, however their relative efficacies are unclear. We compared the efficacy of the inhaled antibiotics tobramycin (TIP, TIS-T, TIS-B), colistimethate sodium (colistin) and aztreonam lysine for inhalation (AZLI) based on data from randomised controlled trials.

Methods

In the base case, efficacies of antibiotics were compared using a network meta-analysis of seven trials including change from baseline in forced expiratory volume in 1 second (FEV1) % predicted, P. aeruginosa sputum density and acute exacerbations.

Results

The tobramycin preparations, AZLI and colistin, showed comparable improvements in efficacy in terms of FEV1% predicted at 4 weeks; the difference in % change from baseline (95%CrI) for TIP was compared to TIS-T (- 0.55, - 3.5;2.4), TIS-B (- 0.64, - 7.1;5.7), AZLI (3.64, - 1.0;8.3) and colistin (5.77, - 1.2;12.8).

Conclusion

We conclude that all studied antibiotics have comparable efficacies for the treatment of chronic P. aeruginosa lung infection in CF.

Keywords

Cystic fibrosis
Pseudomonas aeruginosa
Inhaled antibiotics
Tobramycin
Network metaanalysis

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